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Objective: The WHO recommends that low birth weight infants receive donor human milk (DHM) when mother’s milk is not available. Systematic reviews have been published regarding clinical outcomes of infants receiving DHM, as well as the impact of pasteurisation on the composition of DHM; however, information about milk bank donors has not been systematically assessed. Design: We conducted a systematic scoping review of original research articles about milk bank donors published before August 2020. Setting: Globally. Participants: Donors to milk banks. Results: A total of twenty-eight studies were included across a variety of geographies: the USA (n 8), Brazil (n 7), Spain (n 4), India (n 2), and single studies in France, Norway, Poland, Italy, Taiwan, Korea and China. Study variables were grouped into six main categories: Donor Demographics (n 19), Clinical Characteristics (n 20), Donor Experiences (n 16), Donation Patterns (n 16), Lifestyle Characteristics (n 4) and Lactation/Breast-feeding History (n 8). Some demographic characteristics were commonly reported across regions, while other, including gender and race, were infrequently explored. Factors that might influence the composition of DHM, including birth timing (term or pre-term), milk type (colostrum, transition or mature) and maternal diet were not regularly studied. Other gaps in the literature included (1) donors’ motivations and barriers to donation, (2) lactation and breast-feeding history, including factors that influence donors to pump and amass surplus milk, and (3) donation patterns, including whether donors are also selling milk to corporations or sharing milk with peers. Conclusion: What is known about milk bank donors in different geographies is often limited to a single study, with heterogeneity in the variables reported.

Natural mother’s breast milk is the best food for all newborns, especially preterm babies. However, if mother’s milk is unavailable or donor breast milk (DBM) is inadequate, DBM is the next best choice. Human milk pasteurizers are traditionally big, costly, and require special electrical and water connections, as well as need a large volume of water that is not recycled and an ongoing supply of disposable plastic bottles. Operation of these machines necessitates specialized training. The creation of Kimie, a compact, automated, and user-friendly human breast milk pasteurizer capable of pasteurizing small volumes of DBM, is described here. This system needs no special water plumbing, recycles water, and is reasonably priced.

Background Donor milk is the standard of care for hospitalized very low birth weight (VLBW) infants when mother's milk is unavailable; however, growth of donor milk-fed infants is frequently suboptimal. Variability in nutrient composition of donated milk complicates the production of a uniform pooled product and, subsequently, the provision of adequate nutrition to promote optimal growth and development of VLBW infants. We reasoned a machine learning approach to construct batches using characteristics of the milk donation might be an effective strategy in reducing the variability in donor milk product composition. Objective The objective of this study was to identify whether machine learning models can accurately predict donor milk macronutrient content. We focused on predicting fat and protein, given their well-established importance in VLBW infant growth outcomes. Methods Samples of donor milk, consisting of 272 individual donations and 61 pool samples, were collected from the Rogers Hixon Ontario Human Milk Bank and analyzed for macronutrient content. Four different machine learning models were constructed using independent variable groups associated with donations, donors, and donor-pumping practices. A baseline model was established using lactation stage and infant gestational status. Predictions were made for individual donations and resultant pools. Results Machine learning models predicted protein of individual donations and pools with a mean absolute error (MAE) of 0.16 g/dL and 0.10 g/dL, respectively. Individual donation and pooled fat predictions had an MAE of 0.91 g/dL and 0.42 g/dL, respectively. At both the individual donation and pool levels, protein predictions were significantly more accurate than baseline, whereas fat predictions were competitive with baseline. Conclusions Machine learning models can provide accurate predictions of macronutrient content in donor milk. The macronutrient content of pooled milk had a lower prediction error, reinforcing the value of pooling practices. Future research should examine how macronutrient content predictions can be used to facilitate milk bank pooling strategies.

Background Human milk banks (HMBs) are essential facilities for the selection, collection, testing, transportation,storage, and distribution of DHM for special medical needs. The aim of this analysis was to analyze the operation status and data over the last 8 years of operation of the first human milk bank (HMB) in East China. Methods Data related to the costs, donors, donation, pasteurization, and recipients were extracted from the web-based electronic monitoring system of the HMB for the period August 1, 2013 to July 31, 2021. Results Over the 8 years of operation, 1,555 qualified donors donated 7,396.5L of qualified milk at a cost of ¥1.94 million($306,051), with the average cost per liter of donor human milk being ¥262.3($41.4). The donors were between 25 and 30 years of age, and the majority (80.1%) were primipara. All the donated milk was pasteurized and subjected to bacteriological tests before and after pasteurization: 95.4% passed the pre-pasteurization tests, and 96.3% passed the post-pasteurization tests. A total of 9,207 newborns received 5,775.2L of pasteurized donor milk. The main reason for the prescription of donor human milk was preterm birth. As a result of continuous quality improvements, January 2016 witnessed a significant increase in the volume of qualified DHM and the number of qualified donors. However, in 2020, as a result of the restrictions related to the COVID-19 pandemic, the volume of qualified DHM and the number of qualified donors decreased. Conclusions Over its 8 years of operation, our HMB has made steady quality improvements in its screening and information processes. Continuous quality improvement is on ongoing need, along with recruiting more qualified donors and collecting donor human milk for vulnerable newborns.

Preterm infants are particularly vulnerable to developing iodine deficiency. Donor human milk (DHM) is the preferred feeding option if the mother’s own milk (MOM) is not available, but information on DHM iodine concentration (DHMIC) is lacking. Hence, we aimed to assess DHMIC to further evaluate the adequacy of iodine provision in preterm infants. Finally, associations that might influence DHMIC were studied. In 113 donors, we measured iodine intake by evaluating dietary records for five consecutive days with the DIAL® Software. From the second day of dietary record, donors provided human milk samples (at least one per day) for four consecutive days. Daily human milk samples were analyzed for DHMIC. A DHMIC ≥ 200 µg/L was considered an adequate iodine content for preterm infants. DHMIC and urine iodine concentration (UIC) were determined using ICP-MS. In our study, 83.2% of donors had a full-term infant. Breastfeeding time range was 1.5–49.4 months. During the dietary record, 55.8% took iodine-containing supplements, providing 40–200 µg/day of iodine. The medians (p25, p75) UIC and DHMIC were 112.4 (75.8, 160.1) and 148.5 (97.6, 206.1) µg/L, respectively. In this iodine-sufficient population, 70% had a DHMIC of

Introdução: O Aleitamento Materno é o modo mais seguro, natural e saudável de alimentação para um recém-nascido, na qual é recomendado o aleitamento materno exclusivo até os seis meses de vida apesar dos inúmeros benefícios, pesquisadores apontam uma baixa frequência de aleitamento materno. Objetivo: Identificar a maior prevalência de queixas que acometem as doadoras de leite humano, que procuram o Banco de Leite Humano de uma Maternidade Escola em Alagoas. Metodologia: Estudo transversal, através de registros cadastrais de 2.909 puérperas doadoras entre 2015 a 2018. Os dados coletados foram apresentados e realizou-se uma análise descritiva. Resultados: A faixa etária mais frequente das puérperas foram 28 e 39 anos. As principais queixas relatadas foram: lactação e lesão mamária, mamas cheias (13,5%) e fissuras (5,6%). Encontraram-se associações estatisticamente significativas entre as queixas e as idades maternas - fissuras: 29 anos; mamas cheias: 25,9 anos. A doação voluntária do leite fora o principal motivo da procura ao Banco de Leite Humano, pois no serviço recebiam informações sobre a importância e os benefícios do aleitamento. Conclusões: É perceptível, que a busca pelas puérperas demonstra a escassez de informações, sendo esse serviço fundamental na orientação e conduta desses problemas.

Premature birth complicates 5 to 8% of pregnancies worldwide. The efforts of the medical world are aimed at improving the care of premature infants, which is much more successful – increasing the proportion of extremely premature surviving infants, improving the health and quality of life of premature infants. Such measures include, in particular, the early start of enteral feeding. It is its early initiation that is complicated by the delay in establishing lactation in the mother. To overcome this contradiction, it is proposed to use donor breast milk, for the procurement and storage of which human milk banks have been created. The objective: to analyze the activities of the human milk bank of the Kyiv Perinatal Center in 2020. Materials and methods. To evaluate the activity of the breast milk bank the main indicators of its work for 2020 were analyzed – the total number of donors, their distribution by age, total milk volume, average milk volume per woman, duration of donor milk to newborns. Results. During 2020, 65 donors took part in the breast milk donation program, who received 8,603 portions of milk and 8,220 portions were given to recipients for consumption. It is established that the main source of information for breast milk donors is the staff of the Perinatal Center, and therefore – the main motivation to participate in the program is the desire to help in the care of premature infants. The main pool of recipients (67.1%) are patients of the intensive care unit. A small part of the donor milk was consumed by patients of the postnatal care department and the second stage of nursing. Among patients receiving donor breast milk in the intensive care unit, preterm weight categories of 1000–1499 g (49.3%) and 1500–1999 g (32.7%) dominated. Conclusions. 1. The main source of information about the breast milk donation program is the staff of the Perinatal Center of Kyiv (32.3%), which determines the main motivation of the study participants. The prospect of developing the idea of ​​breast milk donation in Ukraine is popularization in the media in order to expand the audience and encourage women who have given birth in other obstetric facilities. 2. The main pool of DHM recipients in the Perinatal Center of Kyiv are premature patients of the intensive care unit. The largest proportion of patients receiving DGM were in the weight category of 1000–1499 g. The average duration of consumption of DGM by patients in this department is 6.5±0.9 days.

Este estudo tem como objetivo compreender os usos de si nas situações de trabalho de profissionais de enfermagem inseridas em um banco de leite humano (BLH), localizado em uma capital do sudeste do Brasil. Para a produção de dados da pesquisa, utilizou-se da abordagem qualitativa e foi feito levantamento documental, com observação participante no setor por um período de 3 meses e geração de diário de campo. Além disso, foram quatorze entrevistas individuais semiestruturadas e um grupo de discussão com as participantes que se disponibilizaram. A pesquisa mostrou como a ergologia contribui para a compreensão do trabalho nas organizações. Os usos de si dessas profissionais, permeadas por experiências, histórias e valores, estão presentes no contexto e produzem melhorias significativas no setor de BLH. As análises colocaram em evidência como as profissionais se engajam no cuidar, visando fazer o que pensam ser o melhor para os outros. Sendo assim, as profissionais renormalizam suas atividades em um meio repleto de prescrições técnicas, fazendo usos de si e transformando o trabalho.

The retention of human milk (HM) fat in nasogastric probes of infusion pumps can be observed during the feed of infants unable to suck at the mother’s breast. The lack of homogenisation of HM could contribute to the fat holding. Therefore, the present study evaluated (i) the influence of homogenisation on milk fat retaining in infant feeding probes and (ii) the in vivo effect of the homogenisation on lipid absorption by Wistar rats. The animals were fed with HM treated following two processing conditions, that is, pasteurised and homogenised–pasteurised. The animals were randomly subdivided into four experimental groups: water-fed (control), pasteurised milk, homogenised–pasteurised milk and pasteurised–skimmed milk. The results of food consumption, mass body gain, corporate metrics and plasma blood levels of total cholesterol did not show any difference (P < 0·05) among the three types of HM used in the experiments. The liver, intestine and intra-abdominal adipose tissue of the four groups of animals presented normal and healthy histology. The composition of fatty acids in the brain tissue of animals fed with homogenised HM increased when compared with the groups fed with non-homogenised HM. These values were 11·08 % higher for arachidonic acids, 6·59 % for DAH and 47·92 % for nervous acids. The ingestion of homogenised HM promoted higher absorption of milk nutrients. Therefore, the addition of the homogenisation stage in HM processing could be an alternative to reduce fat retention in probes and to improve the lipids’ absorption in the body.

Background: Premature babies have physiological vulnerabilities that influence their absorption and digestion capacity, compromising their clinical condition. Human milk from human milk banks has contributed enormously to providing these newborns with complete nutrition. Objective: To evaluate the quality of human milk collected at the Human Milk Bank during its distribution in neonatal units. Methods: A cross-sectional study, with a quantitative approach, was carried out in a maternity hospital with Human Milk Bank. After the pasteurization of milk and its consequent release to these units, a new test was carried out for the analysis of acid titration, caloric and microbiological content. Results: Human Milk showed a decrease of approximately 20% in caloric content and a reduction in acidity. Approximately 12.3% of the samples were contaminated by fecal coliforms. Conclusion: There is a need for a second moment of evaluation of human milk, after the flow, or to rethink the new ways of preserving the initial quality of human milk.

There are efforts underway to make “breastmilk” called Biomilq through cell culture, “to produce cultured human breastmilk using patent-pending technology in order to offer families a more nutritious and more sustainable option for feeding babies.” However, Biomilq advocates have not explained their claims that the product would be better for infants’ health or for the environment. Their claim that the product would be breastmilk and not a breastmilk substitute is not convincing. They argue that until now women who cannot or choose not to breastfeed have no alternative but to feed with infant formula, but they ignore options such as mothers expressing their own milk or using wet-nurses. They do not mention the possibility of feeding with pasteurized human milk from other women, obtained through a human milk bank. The prospects for Biomilq do not look promising.

BACKGROUND Human milk donation depends on biological factors that are associated with milk production and social factors including donor’s age, literacy, culture and economic status. Understanding donors’ experiences and their attitudes towards donation is important as it will help improve milk donation and motivate potential donors. The aim of this study was to describe the attitude and experiences of the donor mothers in the Human Milk Bank (HMB). METHODS This was a descriptive study conducted in the Human Milk Bank (HMB) attached to this hospital with a time bound sample of 50 mothers who have donated their milk at least once. A questionnaire with 14 questions based on the concepts of the Theory of Planned Behaviour (TPB) including the 5 characteristics of attitude, subjective norms, behaviour control, behaviour intentions, and behaviours was framed and administered. The study was conducted in April and May 2020. RESULTS Breast engorgement (36 %) and the donors having a sick neonate unable to feed (40 %) were the main reasons for milk donation. Two thirds of the donors were not aware about the contra-indications for donating milk to HMBs. Health care workers (74 %) were the major motivators and three fourths of the spouses were supporters of milk donation. Majority of the mothers (88 %) did not desire any monetary renumeration for milk donation and about two thirds were willing to continue donation after going home if a collection facility is available nearby. About 90 % of the donors did not feel inadequacy of milk for their baby or have experienced any pain or discomfort during the milk donation. CONCLUSIONS Educating the donors about the contra-indications to milk donation and the safety protocols followed in the HMBs, educating the family members about milk donation and establishment of collection centers in the communities will bridge the demand supply gap in Pasteurized Donor Human Milk (PDHM) and ultimately reduce the neonatal mortality and morbidity

Background: The pasteurization is a mandatory step to inactivate pathogenic microorganisms of bank milk. For storage, freezing and thawing are necessary. The concentration of macronutrients and ene...

The present aim was to assess the current level of knowledge on human milk bank among antenatal mothers in both rural and urban areas. A quantitative approach with comparative research design was used for the present study.60 antenatal mothers among which in an urban group (n=30) and rural group (n=30) were selected by using a non-probability convenience sampling technique. Self- structured questionnaire method was used to collect both the demographic data and the existing level of knowledge on human milk bank among antenatal mothers. Among 60 study participants, the mean score of the existing level of knowledge among antenatal mothers in the rural area was 9.57 with standard deviation 3.25 and the mean score of the existing level of knowledge in the urban area was 6.60 with standard deviation 2.79. The mean knowledge difference score was 2.97. The comparison of the existing level of knowledge score on human milk bank was calculated using unpaired ’t’ test, the value of t = 3.785 was found to be statistically highly significant at p

Background: Provision of pasteurized donor human milk, as a bridge to mother’s own milk, is the standard of care for very low-birth-weight infants in hospital. The aim of this research was to confirm that Holder pasteurization (62.5°C for 30 min) would be sufficient to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in donated human milk samples. Methods: We spiked frozen milk samples from 10 donors to the Rogers Hixon Ontario Human Milk Bank with SARSCoV-2 to achieve a final concentration of 1 × 107 TCID50/mL (50% of the tissue culture infectivity dose per mL). We pasteurized samples using the Holder method or held them at room temperature for 30 minutes and plated serial dilutions on Vero E6 cells for 5 days. We included comparative controls in the study using milk samples from the same donors without addition of virus (pasteurized and unpasteurized) as well as replicates of Vero E6 cells directly inoculated with SARS-CoV-2. We reported cytopathic effects as TCID50/mL. Results: We detected no cytopathic activity in any of the SARS-CoV-2–spiked milk samples that had been pasteurized using the Holder method. In the SARSCoV-2–spiked milk samples that were not pasteurized but were kept at room temperature for 30 minutes, we observed a reduction in infectious viral titre of about 1 log. Interpretation: Pasteurization of human milk by the Holder method (62.5°C for 30 min) inactivates SARS-CoV-2. Thus, in the event that donated human milk contains SARS-CoV-2 by transmission through the mammary gland or by contamination, this method of pasteurization renders milk safe for consumption and handling by care providers. Trial registration: Chinese Clinical Trial Registry, No. ChiCTR2000031301.

Human milk (HM) constitutes the first immunological barrier and the main source of nutrients and bioactive components for newborns. Immune factors comprise up to 10% of the protein content in HM, where antibodies are the major components (mainly IgA, IgG, and IgM). In addition, antibacterial enzymes such as lysozyme and immunoregulatory factors such as soluble cluster of differentiation 14 (sCD14) and transforming growth factor β2 (TGF-β2) are also present and play important roles in the protection of the infant's health. Donor milk processed in HM banks by Holder pasteurization (HoP; 62.5°C, 30 min) is a safe and valuable resource for preterm newborns that are hospitalized, but is reduced in major immunological components due to thermal inactivation. We hypothesized that high hydrostatic pressure (HHP) and high-pressure homogenization (HPH) are 2 processes that can be used on HM to reduce total bacteria counts while retaining immunological components. We studied the effects of HHP (400, 450, and 500 MPa for 5 min applied at 20°C) and HPH (200, 250, and 300 MPa, milk inlet temperature of 20°C) applied to mature HM, on microbiological and immunological markers (IgA, IgG, IgM, sCD14, and TGF-β2), and compared them with those of traditional HoP in HM samples from healthy donors. The HHP processing between 400 and 500 MPa at 20°C reduced counts of coliform and total aerobic bacteria to undetectable levels (

Objective: To analyze the uses of itself in work situations of nursing professionals inserted in a human milk bank (HMB) located in a capital of southeastern Brazil. Method: In order to produce research data, we followed some procedures: documentary survey; participant observation in HMB for a period of 3 months with generation of field diary; fourteen individual and semi-structured interviews with the participating professionals, besides the accomplishment of a discussion group with the participants who made themselves available. Result: Based on the analytical categories, we became able to understand the dramatic uses of itself in the actions, the values involved and the experiences lived by these employees and what guided their actions, in addition to highlighting the re-normalizations held to execute the activities proposed to them. Remembering that all the names cited are fictitious. The research revealed the importance of the uses made by HMB nursing workers aiming at providing a quality and humanized health service. Conclusion: Professionals re-normalize their activities in an environment of many technical prescriptions, justifying it as a necessary means to achieve the expected results. Such re-normalizations are the result of the use of themselves by the professionals who are engaged in the activity, doing what they think is the best for the other, either it is a nursing professional or patient of the organization. For this purpose, they use their perceptions, preferences and values, as envisaged by the Analytical Ergology

Objectives: An increase in pasteurized human milk contamination with Bacillus cereus was witnessed in milk donated to the Amiens-Picardie Human Milk Bank over the 2017–2018 period. To better unders...

OBJECTIVE. To describe the epidemiological profile of donors and recipients of a Human Milk Bank at a referral hospital in the State of Mato Grosso do Sul. METHODS. This is a descriptive cross-sectional study with retrospective data from the Milk Banks Network system and secondary data from medical records of a tertiary public hospital, between January and December 2017. Descriptive statistics was performed using the Statistic Package for Social Sciences (SPSS®), version 25.0. RESULTS. In 2017, 383 human milk donors were registered, totaling a volume of approximately 614 liters of donated milk. Of this total, 88.51% donors lived in the city of Campo Grande, state capital; 56.40% reported no paid activity; the mean age was 27.45 years; and 79.63% had prenatal care in the public network. Of the 149 recipients, 71.1% (n = 106) were premature with a median gestational age of 34.00 weeks (minimum 21.00 and maximum 42.00); and birth weight with a median of 2225.00 (minimum 660.00 and maximum 5230.00). Also, 61.1% (n = 91) of the recipients weighed less than 2,500 grams and were distributed in: extremely low weight 0.7% (n = 1); very low weight 11.4% (n = 17); low weight 49.0% (n = 73); and normal weight 38.9% (n = 58). CONCLUSION: The donors are young women who had support from the Unified Health System for the prenatal assistance. Among human milk recipients, 61.1% are premature babies weighing less than 2,500 grams.

Background Donor human milk is the best alternative for preterm infants when their mother’s own milk is insufficient or unavailable. The development of human milk banks in China started late, and in most of these banks, the amount of donor human milk is insufficient for clinical demand. Moreover, many mothers are reluctant to use donor human milk due to safety concerns. It is important to understand the potential supply and demand of donor human milk before establishing a new human milk bank. This study aimed to understand women’s acceptance of human milk banking in Wenzhou, southeastern China. Methods A cross-sectional study was conducted in three community health centers in Wenzhou, southeast China, in December 2020. Data were collected from 305 postpartum women selected through convenience sampling. Sociodemographic, perinatal and breastfeeding characteristics, awareness and knowledge of human milk banking and willingness to donate human milk, and to accept donor human milk were assessed. Multivariable logistic regression analysis was used to explore independent predictors of willingness to donate human milk and to accept donor human milk. Results Only 17% (52/305) of our participants had heard of human milk banking prior to this survey. The prevalence of willingness to donate human milk and use donor human milk in our study was 73.4% (224/305) and 44.6% (136/305), respectively. Employment (adjusted odds ratio [AOR] 2.30; 95% confidence interval [CI] 1.17, 4.50) and human milk banking knowledge (AOR 1.23; 95% CI 1.12, 1.35) were independent predictors of willingness to donate human milk. Monthly household income in the previous year (AOR 2.18; 95% CI 1.17, 4.06), awareness of human milk banking (AOR 2.41; 95% CI 1.24, 4.67) and knowledge of human milk banking (AOR 1.22; 95% CI 1.11, 1.35) were significantly associated with willingness to accept donor human milk. Conclusions In our study, awareness of human milk banks among women in the first year postpartum was low. More mothers were willing to donate human milk than to use donor human milk to feed their children. In our study, knowledge of human milk banking was a predictor of both willingness to donate human milk and willingness to use donor human milk. Programs with detailed information on human milk banking are needed to help mothers improve their knowledge and increase acceptance of human milk banking.

Background Donor human milk (DHM) became available in Japan when the first human milk bank was established in 2017. This study investigated the effects of DHM on enteral nutrition (EN) in very low birth weight (VLBW) infants in the single center in Japan. Methods Seventy-six VLBW infants hospitalized between April 2017 and March 2020 at Showa University Hospital were included in the study. We retrospectively evaluated age (hours) at which EN was initiated and age (days) until complete feeding (EN > 100 mL/kg/day) was achieved. We compared the DHM and non-DHM groups, or the early human milk (EHM) and non-EHM groups. The EHM group was defined as those in which EN was initiated with the mother's own milk or DHM within 12 h of birth. Results In 30 extremely low birth weight (ELBW) infants, EN was initiated at significantly earlier postnatal hours in the DHM group compared to those in the non-DHM group. Complete feeding was achieved at significantly earlier ages in the EHM group after adjusting for gastrointestinal complications and gestational age. Additionally, the changes in body weight z-scores from birth to term-equivalent age were significantly greater in the EHM group after adjusting for exclusive breastfeeding and small for gestational age, compared to the non-EHM group. Statistical significance was not noted in 46 subjects (birth weight, 1000-1500 g). Conclusions The use of DHM may contribute to earlier initiation and achievement of EN, resulting in greater early postnatal growth in ELBW infants in Japan.

This study aimed to evaluate the application of thermosonication for the viability of Staphylococcus aureus and the antioxidant activity of HM. The US effect on the S. aureus was measured by counting viable cells in discarded HM immediately before and after different treatments varying time (1, 5 and 10 minutes) and temperature (20, 30, 40, 50 and 60 °C) through surface plating on standard agar. The antioxidant activity evaluation was carried out by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging method. With Regarding microbiological quality, it can be concluded that treatment with US at 60 °C for 10 minutes was the most effective in terms of reducing the viability of S. aureus, in addition to presenting a significant increase in the content of antioxidants when compared to raw and pasteurized milk samples.

Background: Microbiological quality is one of the key safety standards in human milk bank (HMB) operations. We describe the profiles of bacteria in donor human milk (DHM) before and after the pasteurization of samples collected from breastfeeding women in the hospital and from the community in the first HMB in Vietnam. Methods: Data were collected between February 2017 and January 2022 from an online HMB monitoring system. First, DHM samples were cultured, and the number of colony-forming units (CFU) were counted before (n = 708) and after pasteurization (n = 1146). The gram-staining method combined with the Vitek 2 Compact system were used to identify types of organisms at the Da Nang Hospital for Women and Children’s Laboratory. Passing criteria for DHM included pre-pasteurization samples had a total colony count

Background Human milk is the best nutrition for all infants. When this is not available, the use of donor human milk through human milk banks (HMBs), is recommended. The aim of the study is to explore Italian women's knowledge and attitude towards human milk donation and HMB. Methods A web-based self-administered 20-item questionnaire was developed based on the literature review and distributed via the social networking site Facebook. Results 3290 women completed the survey. Of those 76.57% knew about the opportunity to donate human milk and 72.37% were aware of the existence of HMBs, most of them breastfed for more than 6 months. Altruism towards other mothers and having an abundant milk supply, were found to be the most important facilitators that should lead women to donate their own milk. The most important barrier was lack of information (91.25%). A high rate of women who breastfed longer than 6 months expressed issues related to collection and transportation; concerns regarding the time needed to express was reported mainly by women currently breastfeeding. Conclusions This is the first Italian study to investigate this topic. Advertising to inform the general public should be used to increase awareness, short sessions within the school programme might sensitize women from a very young age. Healthcare professionals should strive to divulgate appropriate information.

Introduction: World Health Organization actively promotes breastfeeding as the best nourishment source for infants and young children. However, access to human milk for all newborns is not always possible, leading to nutritional benefits deprivation or financial burden related to acquiring alternatives. Establishing human milk banks (HMB) could facilitate equitable access to donated human milk. However, various factors may impede human milk donation. This study identifies factors influencing milk donation to HMB in Iran. Methods We conducted a case-control study among mothers who had given birth at least one year before the study, with 51 cases (mothers who donated their milk to HMB) and 153 controls. Data were collected by a questionnaire designed to obtain retrospective information about individual health, social network, and other factors. Logistic regressions were used to examine relationships between breast milk donation and these factors. Qualitative data were collected during face-to-face interviews and analysed using a content analysis approach to elicit viewpoints of HMB senior staff and mothers on the factors influencing milk donation. Results Family factors, social factors, individual social welfare score, and breast milk adequacy were associated with increased milk donation. Family support for human milk donation was among the strongest predictors. Conclusion To establish HMB and promote human milk donation, health policy planners and makers should use strategies and policies that motivate mothers' donation to HMBs.

Os bancos de leite humano (HMBs) estão sujeitos a doações reduzidas e coleta de descarte para processamento. Objetivo: Identificar as causas do desperdício de leite humano no HMB. Materiais e métodos: Estudo descritivo, retrospectivo e transversal dos dados secundários registrados nos arquivos dos prontuários no HMB Information durante o processamento, sendo necessário identificar as principais causas de desperdício do Sistema de um hospital público terciário, em relação a doadores de leite humano e recém-nascidos receptores, entre janeiro e dezembro de 2000. 2017. A análise estatística descritiva foi realizada pelo Statistic Package for the Social Sciences versão 25.0. Resultados: foram selecionados 383 doadores e 149 recém-nascidos que receberam leite humano que possuíam registros completos no sistema. Do volume inicial (711.854,14 mL de leite humano), o 13. 74% dos resíduos foram concentrados nas fases de seleção e classificação (9,04%). As causas do desperdício de leite humano foram acidez Dornic (6,98%), condição de sabor desagradável (5,50%) e sujeira (2,01%). O desperdício de leite humano concentrado na fase de seleção e classificação. Conclusão: As causas do desperdício de amostra nas fases de seleção e classificação são a alta acidez Dornic, a condição de sabor ruim e a sujeira. A recomendação é orientar a coleta pela equipe do HMB aos doadores para reduzir o desperdício no banco de leite humano. condição sem sabor e sujeira. A recomendação é orientar a coleta pela equipe do HMB aos doadores para reduzir o desperdício no banco de leite humano. condição sem sabor e sujeira. A recomendação é orientar a coleta pela equipe do HMB aos doadores para reduzir o desperdício no banco de leite humano.

Appropriate decontamination of breast pump milk collection kits (BPKs) is critical to obtain safe milk for infants and to avoid discarding donor human milk (DHM).To evaluate two strategies for BPK decontamination by assessing microbial cultures and the proportion of discarded DHM, according to the criteria of the National Institute for Health and Care Excellence for pre-pasteurization cultures.Prospective comparative study, allocation ratio 1:1, microbiologist-blind.47 new donors in a human milk bank in Madrid.Study group (N=21): BPKs washed with water and detergent after each use and further steam decontamination within a microwavable bag. Control group (N=26): washing, rinsing and drying only. Five samples: first sample by hand expression and four samples (one per week) collected using the same pump and method.Primary: proportion of DHM discarded due to contamination. Secondary: comparison of the microbiota between samples obtained by hand expression and breast pump in both groups.In total, 217 milk samples were collected: 47 by hand expression and 170 by pump expression (78 from study group). Steam decontamination of BPKs using a microwavable bag after washing resulted in a lower proportion of discarded DHM samples (1.3% vs 18.5%, P0.001) and samples contaminated with Enterobacteriaceae (1.3% vs 22.8%, P0.001) and Candida spp. (1.3% vs 14.1%, P0.05) compared with samples collected with BPKs that were washed but not steam decontaminated. There were no differences in bacterial contamination between samples obtained using steam decontaminated BPKs and those obtained by hand expression.Steam decontamination of BPKs using a microwavable bag after washing decreases the amount of discarded DHM and the number of samples with potentially pathogenic bacteria.

Better understanding of the variation in macronutrient content of human donor milk (HDM) potentiates targeted nutrition for preterm babies. The present study describes the relationship of maternal age, parity, monthly lactation stage estimate (LSEm), daily volume of milk expressed (Vd), sex, gestation and birth weight z scores with macronutrient content of HDM. Multilevel mother–infant pair ID random intercept models were performed using the predictor variables above on the outcome HDM macronutrient content determined using mid-IR spectroscopy. Mean macronutrient content was also compared by gestational age and small for gestational age (SGA) (z score z score ≥ –1·28) categories. A total of 2966 samples of donations from 1175 mother–infant pairs to the UK Northwest Human Milk Bank between 2011 and 2017 were analysed. Mean protein, fat, carbohydrate and calculated energy were 0·89 (SD 0·24) g/dl, 2·99 (SD 0·96) g/dl, 7·09 (SD 0·44) g/dl, and 60·37 (SD 8·41) kcal/dl (252·59 (SD 35·19) kJ/dl), respectively. Preterm SGA HDM was significantly higher in protein, fat and energy content than term AGA HDM and significantly lower in carbohydrate content than term AGA HDM after controlling for LSEm, Vd and between-subject effects. Degree of prematurity did not influence macronutrient content. Between-subject effects accounted for more of the variance in macronutrient content than the fixed effects in the model. Despite this, SGA status, as well as prematurity, may be an important determinant of macronutrient content in human milk. As bioavailability of macronutrients from HDM is uncertain, studies evaluating growth and body composition in preterm and SGA babies fed HDM are warranted.

Human milk is a dynamic food and some important differences in composition can be found between the milk from preterm and terms infants. Additionally, in some situations, the mother's own milk is unavailable and the use of milk from human milk banks is considered as the most appropriate substitute. In this way, concentrations of trace elements (Ba, Cu, Fe, Mn, Mo, Se, Sr, and Zn) were determined in human milk, considering the differences about preterm and term human milk and its processing in a human milk bank.A total of 156 samples were analyzed, which were divided in three groups: samples collected at the hospital at bedside (BS, 60 samples) from mothers of preterm infants and samples from mothers of term infants collected in a human milk bank without pasteurization (WP, 49 samples) and pasteurized by the Holder procedure (P, 47 samples). The analyzes were conducted by inductively coupled plasma mass spectrometry (ICP-MS) after the treatment of the samples with acid mineralization assisted by microwave radiation.Concentrations varied in a range of 0.6-88.2 μg/L for Ba, 78.6-954.5 μg/L for Cu, 24.2-5229.2 μg/L for Fe, 0.4-42.6 μg/L for Mn, 0.1-39.1 μg/L for Mo, 2.5-70.6 μg/L for Se, 8.9-187.5 μg/L for Sr and 76.3-17727.2 μg/L for Zn. Significant differences (p 0.05) were found between preterm (BS) and term human milk (WP and P) for Ba, Cu, Mo, Se, and Zn, whereas the processing of the donated milk by Holder pasteurization did not influence the concentration of the studied trace elements. The milk of term infants does not attend the recommended daily intake (RDI) of Zn and for preterm infants the RDI of Fe and Mn is not achieved.The higher concentrations of Cu, Mo, Se and Zn observed in milk from mothers of preterm infants indicate that the milk to be offered for these high-risk neonates in neonatal intensive care units should contain higher levels of these trace elements. Besides, considering the RDI, the milk of term infants should be fortified with Zn, whereas the milk of preterm infants should be fortified with Fe.

A prototype of microwave pasteurizer has been proposed as an alternative for holder pasteurization (HP) routinely used in Human Milk Bank (HMB), ensuring microbiological safety of human milk (HM). It was shown that the time of heat generation was about 15–16 min shorter by applying the microwave than in HP. Total inactivation of heat-sensitive bacteria Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis, suspended in milk, occurred in the temperature 62–72 °C in HP. In the case of heat-resistant enterococci the level of inactivation depended on the conditions of the process and the properties of the strains. The application of microwave heating allows to obtain lower D-value than those achieved during HP. The using of microwave heating at 62.5 or 66 °C for 5 or 3 min, respectively, allows to inactivation of HM microbiota. Appropriate microbiological quality of milk is critical for the effectiveness of the pasteurization process. Industrial relevance Looking for new methods of donor human milk (HM) preservation is dictated by the necessity of providing microbiological safety and, at the same time, maintain its high nutritional and biological value. The holder pasteurization used in the Human Milk Banks (HMB) (heating at 62 °C for 30 min) leads to inactivation of all vegetative forms of microorganisms. Unfortunately, this method causes significant reduction of health benefitting properties of HM. The paper demonstrates the possibility of using the new microwave pasteurizer for preservation of HM, allowing for quick heating of milk to the appropriate temperature and maintaining it in these conditions for a required time. It was shown that the decimal reduction times (D) for strains inoculated to UHT or human milk are several times shorter by using microwave heating than in the commercial pasteurization method. The total inactivation of HM microbiota is obtained after heating at 62.5 and 66 °C for 5 and 3 min, respectively.

Aim To analyse the dynamics of macronutrients in breast milk in Slovakian women and compare the dynamics between mothers of hospitalized newborns and donors of human breast milk relative to the gestational age of their babies. Methods Human milk samples were collected from 101 breastfeeding women and analysed once or repeatedly from September 2017 to August 2018. Group A consisted of 79 mothers of newborns hospitalized at the Neonatal Department of Intensive Medicine (NDIM) of whom 69 were mothers of premature newborns (subgroup A1) and 10 were mothers of term babies (subgroup A2). Group B consisted of 22 breast milk donors registered at the Human Milk Bank at National Institute of Children's Diseases (NICHD). Of these, 4 were mothers of premature newborns (subgroup B1) and 18 were mothers of term newborns (subgroup B2). From subgroup A1, we chose two mothers, one with a hypotrophic newborn and another with a eutrophic newborn. The results were obtained by using the MIRIS breast‑milk analyzer. Results The overall dynamics of macronutrients correspond with other studies, however, we demonstrated that the level of macronutrients in individual cases were different. Conclusion The determination of macronutrients in human milk is essential in neonatal care. It provides information about the nutritional value of breast milk and helps to optimise nutrition according to the individual needs of newborns (Fig. 10, Ref. 16).

The number of human milk banks is increasing around the world.1 In many countries, preterm infants born at

Background Clinical guidelines are recommendations produced by systematic methods assisting health care providers in making the right decisions. The existence of Mothers’ Milk Banks (MMBs) plays an important role in increasing exclusive breastfeeding in low birth-weight infants. More than one million infants under one year of age die annually because they are not breastfed. The present study was done to develop a clinical guideline for MMB. Methods The study was a multistage integrated study conducted in three steps according to the NICE model. In the first step, the components of a clinical guideline for MMB were determined through multiple data centers to search and resource integration and a draft was subsequently prepared. In the second step, each component was reviewed considering the expert agreement and the clinical guideline was finally developed. In the third step, the AGREE questionnaire was used by 10 experts to measure the utility and quality of the proposed program as well as its national feasibility. Quantitative data was analyzed in SPSS20 using descriptive statistics. Results The clinical guideline included the necessary measures before MMB development (establishing MMB infrastructure, enhancing awareness for supporting MMB, creating a network for communicating with different units, developing the key rules and guidelines as well as ethical points) and the necessary measures while using MMB (donors, working processes on the donated milk, and the recipients). The content was reviewed by forming a focus group and their corrective comments were considered in the clinical guideline. Utilizing the AGREE tool, the results of the survey showed that 90% of the respondents strongly recommended guideline use. Conclusions It is hoped that this clinical guideline, provided by the order of Neonatal Health Bureau based on the culture and religion of the Iranian community, could be an effective step to improve the care and treatment process of preterm infants. Moreover, with the proper use of it, the treatment team staff can support the premature infants and their parents by promoting breastfeeding and reducing the side effects of using formula and the mortality of this group of infants.

Background The World Health Organization (WHO) recommendations on infant feeding in the context of COVID-19 uphold standing recommendations for breastfeeding, non-separation, and skin-to-skin contact, including the use of donor human milk when mother’s own milk is not available. Insufficient guidance on the use of donor human milk and the role of human milk banks in the pandemic response COVID-19 clinical management guidelines in seven countries in Southeast Asia are not aligned with WHO recommendations despite the lack of evidence of transmission through either breastmilk or breastfeeding. The use of safe donor human milk accessed through human milk banks is also insufficiently recommended, even in countries with an existing human milk bank, leading to a gap in evidence-based management of COVID-19. This highlights long-standing challenges as well as opportunities in the safe, equitable, and resilient implementation of human milk banks in the region. Conclusions This statement reflects the expert opinion of the Regional Human Milk Bank Network for Southeast Asia and Beyond on the need to revisit national guidelines based on the best evidence for breastfeeding during the COVID-19 pandemic, to incorporate human milk bank services in national obstetric and newborn care guidelines for COVID-19 where possible, and to ensure that operations of human milk banks are adapted to meet the needs of the current pandemic and to sustain donor human milk supply in the long-term. The Network also recommends sustained engagement with the global human milk bank community.

Background Mother’s milk is the ideal food for a neonate. When mother’s milk is unavailable for any reason, pasteurised donor human milk (PDHM) is the next best option. This quality improvement (QI) project aimed at improving voluntary donation in a public human milk bank (HMB) in South India. Methods Between January 2018 and June 2019, the HMB received an average of 15 L of donor milk per month (0.5 L/day). Our aim was to increase voluntary donation by 50% from the baseline over a period of 8 months from July 2019 to March 2020 using QI methods. Two plan-do-study-act (PDSA) cycles were done during the intervention period (4 months). Interventions included the formation of micro teams in postnatal wards to promote exclusive breastfeeding and to liaison with the core QI team. We created a milk expression area in the postnatal ward, counseled postnatal mothers, and addressed supply chain issues like sterile pumping accessories. Results The average daily voluntary milk donation to HMB increased from 0.83 L/day in the baseline phase to 1.16 and 1.14 L per day in the intervention and postintervention phases, respectively. The mean (SD) monthly donated volumes increased from 28.2 (6.1) L to 34.1 (3.7) L; mean difference (95% CI) 5.9 (0.33–11.4); P = 0.03. The volume of PDHM disbursed from HMB increased from 26.6 (3.2) L/month to 32.2 (9.2) L/month, although not statistically significant (p = 0.15). The number of mothers donating milk did not increase during the study period. Conclusions A multipronged QI intervention effort focusing on exclusive breastfeeding improved voluntary milk donation in HMB bank. Multiple micro-teams and local networking facilitated the QI initiative.

Donor human milk (HM) obtained at HM banks is exceptionally crucial for the feeding and treatment of preterm infants. Bacterial contaminations of HM in various stages of its handling are very common and can lead to disqualification of donations or severe infections in worse cases. Hence, HM donations are subject to strict bacteriological evaluations pre- and post-pasteurization. The main contaminating species vary between countries, banks and donors and even exhibit inter-individual variation. We initiated an assessment of the bacteriological composition of HM donated by women hospitalized in a neonatal intensive care unit in Israel. The most common bacterium identified was Staphylococcus epidermidis, found in all but one of the HM samples; the presence of several species of coagulase-negative Staphylococci was also noted. Next, we sought to develop a platform towards antibacterial treatment using Zn2+ ions that have recently been found to be potent against contaminants isolated from bovine milk. Zn2+ efficiently inhibited the growth of viable aerobic population and S. epidermidis in HM. Growth was also inhibited in other Gram-positive bacteria such as Bacillus cereus, a well-known food-borne pathogen. S. epidermidis and B. cereus cells grown in the presence of zinc were taken for microscopic evaluation, aiming to demonstrate zinc’s antimicrobial mode of action morphologically. Images obtained using scanning electron microscopy indicated leakage of cellular content and cell lysis in S. epidermidis. Besides, B. cereus cells showed abnormalities in their cell surface and complete loss of flagella upon treatment with zinc. Along with the above findings, it should be noted that this was a pilot study that tested how high doses of Zn2+ affect breast milk as a product. Further research is likely needed on the safety of consumption of Zn2+-treated HM in infants and older children.

espanolIntroduccion: la pandemia originada por el SARS-CoV-2 provoco la declaracion del estado de alarma sanitaria entre marzo y junio de 2020 en Espana. Los bancos de leche materna han visto afectada su actividad durante este periodo, siendo necesario implementar nuevas medidas para promocionar la donacion de leche y disminuir el impacto en la actividad. Metodo y objetivo: el objetivo del estudio es evaluar el impacto del estado de alarma decretado desde el 14 de marzo al 22 de junio de 2020 en el Banco de Leche del Hospital Virgen de las Nieves de Granada, en comparacion con el mismo periodo del ano previo. Para ello se ha realizado un estudio descriptivo retrospectivo en el que se han tenido en cuenta los indicadores de actividad del Banco de Leche de forma global y se han comparado los datos del Banco de Leche del Hospital Universitario Virgen de las Nieves, ubicado en Granada, con los datos de los centros perifericos que colaboran con el mismo. Resultados: durante el primer estado de alarma de 2020 hubo una disminucion global de las inscripciones de nuevas donantes, del numero de donantes que donaron leche, del volumen de donacion media por madre y del volumen total de leche cruda recibida y pasteurizada. A pesar de ello, en el banco de leche de Granada aumentaron las nuevas inscripciones durante este periodo, asi como el numero de donantes que donaron leche. Conclusion: las medidas adoptadas en el banco de leche ubicado en Granada, como incentivar la donacion de leche entre las madres con ninos ingresados en la Unidad Neonatal, aumentar la informacion a las madres y recoger la leche donada a domicilio, permitieron atenuar el impacto de la pandemia, garantizando la seguridad. EnglishIntroduction: the pandemic caused by SARS-CoV-2 led to the declaration of the state of sanitary alarm between March and June 2020 in Spain. The activity of human milk banks was affected during that period, making it necessary to implement new measures in order to promote milk donation and diminish said impact. Method and objective: the aim of the study was to evaluate the impact of the state of alarm decreed from March 14 to June 22, 2020 on the breastmilk bank at Hospital Virgen de las Nieves, Granada, Spain, in comparison with the same period during the previous year. To that end, a retrospective descriptive study was undertaken in which the activity indicators of the breastmilk bank were collected and compared to data from the milk bank at Hospital Virgen de las Nieves and peripheral collaborating centers. Results: during the first state of alarm in 2020 a global reduction was seen in new donor registrations, number of donors who donated milk, donated mean volume per mother, and total volume of received and pasteurized milk. However, new registrations and number of donors who donated milk during this period increased in Granada’s breastmilk bank. Conclusion: the new measures adopted in the breastmilk bank in Granada, such as encouraging milk donation in mothers with admitted newborns in the Neonatal Unit, increasing information given to mothers, and home collection of donated milk, allowed to attenuate the impact of the pandemic while guaranteeing safety.

Introduction: Despite the scientifically recognized benefits of breastfeeding, early weaning is still a reality, being related to multifactorial causes, including breast problems, which can hinder or even interrupt this process. Objective: to estimate the prevalence of breast pain and its associated factors in lactating women attended at a Human Milk Bank. Materials and methods: cross-sectional study based on secondary data from the register of specialized appointments that occurred between January of 2017 and December of 2018, at the Human Milk Bank of the University Hospital of the Federal University of Maranhao (HUUFMA). The data were collected between the months of September and November of 2019, using a form, reproducing it as information from the attendance files, generating a table later in Microsoft Excel, analyzed by the Stata version 14 statistics program. Pearson Qui-square test was used, with a significance level equal to

The superiority of breast milk over milk of other species is already consolidated and there are numerous benefits in the practice of breastfeeding. The Human Milk Bank is a privileged place for the establishment of breastfeeding, as actions to encourage, support and promote breastfeeding are developed. This is a cross-sectional, retrospective study carried out at the only maternity hospital in the city. The sample consisted of mothers and babies assisted by a lactation support program from 2005 to 2016 and also mothers and babies monitored by the human milk bank. It was observed that the assistance of the milk bank was associated with the type of delivery performed (cesarean) (OR: 2.11; 95% CI: 1.03-4.33), having premature children (gestational age) (OR: 3 , 48; 95% CI: 1.52-7.95), higher education (OR: 1.16; 95% CI: 1.03-1.32) and being younger (age) (OR: 0.94; 95% CI %: 0.88-0.99) were the indicators that increased the mother's chance to seek care from the milk bank, regardless of parity and place of residence. The support, protection and promotion of breastfeeding that is carried out in this place, is configured as an important scenario favoring this practice, impacting on the health of the mother-child binomial in the present and in the future.

BackgroundThe need for donor human milk has accelerated both locally and globally. To remain sustainable, human milk banks need to maintain effective recruitment including frequent donations of adequate volumes.Research aimsTo determine (1) which factors influenced mothers’ willingness to give or receive donor human milk, and the influence of (2) socio-demographics, (3) pregnancy, (4) breastfeeding history, (5) prior knowledge of human milk banks, and (6) general factors on milk donations.MethodsThis was a cross-sectional, prospective, descriptive study. Interviewer administered questionnaires were used ( N = 148). Independent sample t-tests and one-sample t-tests were used to determining differences in variables.ResultsThe sample population consisted of mainly single ( n = 104, 70.3%) Black African mothers ( n = 127, 85.8%) who identified as Christian ( n = 97, 65.6%) with a mean age of 24.8 ( SD = 5.63) years. The majority ( n = 120, 81.1%) had no prior knowledge of human milk banks; however, most ( n = 78, 52.7%) were significantly likely to donate. The main factors that influenced the participants’ willingness to donate were altruism ( n = 99, 66.9%), information provided by staff at hospitals/clinics ( n = 92, 62.2%), amount of milk produced ( n = 69, 46.4%), fear of not having enough milk for their own infant ( n = 68, 45.9%), and support from family/friends/partner ( n = 67, 45.3%).ConclusionThere is a strong need to increase visibility and information sharing with potential donor mothers to ensure a sustainable supply and system of human milk banks.

If maternal milk is unavailable, the World Health Organization recommends that the first alternative should be pasteurised donor human milk (DHM). Human milk banks (HMBs) screen and recruit milk donors, and DHM principally feeds very low birth weight babies, reducing the risk of complications and supporting maternal breastfeeding where used alongside optimal lactation support. The COVID‐19 pandemic has presented a range of challenges to HMBs worldwide. This study aimed to understand the impacts of the pandemic on HMB services and develop initial guidance regarding risk limitation. A Virtual Collaborative Network (VCN) comprising over 80 HMB leaders from 36 countries was formed in March 2020 and included academics and nongovernmental organisations. Individual milk banks, national networks and regional associations submitted data regarding the number of HMBs, volume of DHM produced and number of recipients in each global region. Estimates were calculated in the context of missing or incomplete data. Through open‐ended questioning, the experiences of milk banks from each country in the first 2 months of the pandemic were collected and major themes identified. According to data collected from 446 individual HMBs, more than 800,000 infants receive DHM worldwide each year. Seven pandemic‐related specific vulnerabilities to service provision were identified, including sufficient donors, prescreening disruption, DHM availability, logistics, communication, safe handling and contingency planning, which were highly context‐dependent. The VCN now plans a formal consensus approach to the optimal response of HMBs to new pathogens using crowdsourced data, enabling the benchmarking of future strategies to support DHM access and neonatal health in future emergencies.

Aim As the COVID‐19 pandemic evolves, human milk banks world‐wide continue to provide donor human milk to vulnerable infants who lack access to mother's own milk. Under these circumstances, ensuring the safety of donor human milk is paramount, as the risk of vertical transmission of SARS‐CoV‐2 is not fully understood. Here, we investigate the inactivation of SARS‐CoV‐2 in human milk by pasteurisation and the stability of SARS‐CoV‐2 in human milk under cold storage. Methods SARS‐CoV‐2 was experimentally inoculated into human milk samples from healthy donors or into a control medium. Triplicates of each sample were layered onto uninfected cells after Holder pasteurisation (63°C for 30 min), heating to 56°C for 30 min, or after 48 h of storage at 4°C or −30°C. Infectious titres of virus were determined at 72 h post‐infection by endpoint titration. Results Following heating to 63°C or 56°C for 30 min, replication competent (i.e. live) SARS‐CoV‐2 was undetected in both human milk and the control medium. Cold storage of SARS‐CoV‐2 in human milk (either at 4°C or −30°C) did not significantly impact infectious viral load over a 48 h period. Conclusion SARS‐CoV‐2 is effectively inactivated by Holder pasteurisation, suggesting that existing milk bank processes will effectively mitigate the risk of transmission of SARS‐COV‐2 to vulnerable infants through pasteurised donor human milk. The demonstrated stability of SARS‐CoV‐2 in refrigerated or frozen human milk may assist in the development of guidelines around safe expressing and storing of milk from COVID‐19 infected mothers.

Objetivo: identificar a duração do aleitamento materno exclusivo e complementar entre mulheres atendidas no banco de leite humano. Método: estudo retrospectivo de abordagem quantitativa, realizado no período de fevereiro a maio de 2019. A amostra foi composta por 73 mulheres atendidas no banco de leite humano no ano de 2017. A coleta de dados ocorreu por questionário confeccionado no programa Google Docs. Os dados foram analisados no programa Epiinfo versão 3.5.3. A pesquisa foi aprovada pelo Comitê de Ética com parecer 3.265.618. Resultados: A faixa etária variou de 18 a 46 anos, prevalecendo mulheres casadas, primíparas, as quais foram submetidas a cesariana, sendo unânime a realização do pré-natal. A maioria das mulheres praticou o aleitamento materno exclusivo até os seis meses e o complementar por mais de dois anos. Conclusão: Percebe-se que o serviço especializado contribuiu de forma satisfatória e efetiva para a prática do aleitamento materno, considerando-se os percentuais apresentados em suas formas exclusivas e complementar.

Human milk bank involves in some processes like collection, screening, storing and distribution of donated human milk. Thus human milk bank (HMB) provides a vital lifesaving and growth stimulant of golden food to those infants who cannot take their mother’s feed either because of pre-mature delivery. In this the largest groups of recipients mothers are those whose infants are pre-mature or under-weight and are not able to suck the milk from their mother’s breast. Donor mothers are carefully selected and also screened for HIV-1, HIV-2, human T-cell leukemia virus 1 and 2, hepatitis B, hepatitis C and syphilis. However the beneficial effects of donor milk remain significant and donor milk is still highly preferable in comparison to formula. Keywords: Human Milk, Human Milk Bank, HIV-1, HIV-2, HEPATITIS-B & C, Screening Cite this Article Deepika Kapoor, Sanjiv Kalia, Ankit Kalia. Benefits of Human Milk Bank. Research & Reviews: A Journal of Immunology. 2020; 10(2): 1 – 5p.

Nonthermal methods are more efficient at preserving various biological properties of human milk, as compared with holder pasteurization (HoP), which is the most common preservation method. This study was performed to assess the effects of nonthermal processing on bactericidal activity against Escherichia coli in human milk. Milk samples obtained from the Regional Human Milk Bank in Warsaw at Holy Family Hospital were processed by HoP, irradiated with ultraviolet-C (UV-C) for 5, 10, and 15 minutes (6720 J/L each minute), subjected to 2 variations of high-pressure processing (HPP): 450 MPa for 15 minutes and 200 MPa for 10 minutes + 400 MPa for 10 min, with a 10-minutes break. The samples were then evaluated by a bactericidal assay (raw untreated human milk was used as a control). The bactericidal capacity after HoP was preserved in 12.1% of samples, showing a significant reduction in bactericidal properties compared with in raw milk (P 0.05). The differences between samples preserved by nonthermal methods and raw milk were not significant (P 0.05). Nonthermal methods of human milk treatment better preserve the bactericidal capacity compared with holder pasteurisation. Those alternative technologies to HoP can be proposed after further investigation for milk processing for Human Milk Banks facilities.

The effect of high pressure thermal (HPT) processing on the immunoglobulin (IgM, IgA and IgG), and cytokine content (IL-6, IL-8, IL-10, and TNF-α), and antioxidant activity of human milk was analyzed after the application of different treatments between 200, and 800 MPa at low initial temperatures (between −15, and 50 °C) and for 1 s (flash treatments). Low pressures intensities did not induce changes in Igs while at 800 MPa, all combinations reduced the control levels. IL-6 and IL-10 were not affected by any of the treatments applied while IL-8 and TNF-α were reduced at treatments which combined temperatures at 50 °C. In general antioxidant activity was not affected at the processing conditions chosen. The flash HPT treatment applied at 600 MPa and at 0 °C could be the best choice to preserve immunological parameters and the antioxidant activity of human milk.