The Effect of Holder Pasteurization on Nutrients and Biologically-Active Components in Donor Human Milk: A Review

Abstract

When a mother’s milk is unavailable, the best alternative is donor milk (DM). Milk delivered to Human Milk Banks should be pasteurized in order to inactivate the microbial agents that may be present. Currently, pasteurization, performed at 62.5 °C for 30 min (Holder Pasteurization, HoP), is recommended for this purpose in international guidelines. Several studies have been performed to investigate the effects of HoP on the properties of DM. The present paper has the aim of reviewing the published papers on this topic, and to provide a comparison of the reported variations of biologically-active DM components before and after HoP. This review was performed by searching the MEDLINE, EMBASE, CINHAL and Cochrane Library databases. Studies that clearly identified the HoP parameters and compared the same DM samples, before and after pasteurization, were focused on. A total of 44 articles satisfied the above criteria, and were therefore selected. The findings from the literature report variable results. A possible explanation for this may be the heterogeneity of the test protocols that were applied. Moreover, the present review spans more than five decades, and modern pasteurizers may be able to modify the degradation kinetics for heat-sensitive substances, compared to older ones. Overall, the data indicate that HoP affects several milk components, although it is difficult to quantify the degradation degree. However, clinical practices demonstrate that many beneficial properties of DM still persist after HoP.

Impacto De La Pasteurización/Liofilización en El Contenido Disponible De Inmunoglobulinas en Leche Humana Madura. Estudio De Aplicación en Bancos De Leche Humana en Hospitales

“…Estos niveles son mayores a los publicados previamente por Michaelsen en 1990, quién reportó concentraciones de 9 a 12 g/l de proteínas (15). Otros autores reportan que el contenido total de proteínas que incluyen las inmunoglobulinas se reduce por la pasteurización (16).…”

“…Tomando en cuenta que la diversidad en la composición de la LHM en el escenario de la lactancia es dependiente de la etapa y duración de esta, los estudios que evalúan el contenido de inmunoglobulinas reportan resultados controversiales (16), mostrando niveles de 1,0 a 2,0 g/l para IgA, de 0,16 a 0,66 g/l para IgG y de 0,04 a 0,15 g/l para IgM en LHM (16). A este respecto, en las muestras incluidas en este estudio encontramos concentraciones parcialmente similares (IgA 1,29 g/l, IgG 0,57 g/l e IgM 1,56 g/l), mientras que para el complemento C3 se reportan concentraciones de 19,93 ± 1,63 mg/dl para LH en etapa de calostro (16) y 16 mg/dl en LHM (17), que contrastan con los niveles encontrados en nuestro estudio 9,75 ± 2,62 mg/dl.…”

“…A este respecto, en la evaluación de retención de inmunoglobulinas en la LH después de un proceso de pasteurización los reportes son recientes pero escasos, y la información obtenida por otros autores (16,19,(21)(22)(23)) es de 27 a 67%. Específicamente, para IgM en la pasteurización a 62,5 °C durante 30 minutos se reporta pérdida significativa con respecto a la concentración inicial (16,(22)(23)(24).…”

Extending the Reach of Human Milk Banking

“…4. Pasteurization, freezing, and other forms of processing are likely to lead to loss of nutrients or other important factors in the milk (Peila et al 2016). 5.…”

Comments on the High Pressure Preservation of Human Milk

“…However, any protocol associated with approaching or passing the pasteurization threshold, required for reaching the microbiological safety, is associated with the very notable reduction of key nutritional and bioactive features (Peila et al, 2016). The New Hope for banks of human milk can be the implementation of innovative methods based on non-thermal physical treatments (Peila et al, 2017).…”