2. Universidad Cardenal Herrera-CEU

The use of human milk in milk banks requires thermal processing to eliminate microbiological hazards. An evaluation is made of the stability of overall human milk bactericidal capacity following 2 modalities of thermal pasteurization: 63°C/30 minutes and 75°C/15 seconds. Ten milk samples (mature milk) were analyzed. In each sample, the effect of both thermal treatments on bactericidal capacity against Escherichia coli was evaluated in relation to the capacity of fresh milk (control). All the samples analyzed possessed bactericidal capacity. Human milk pasteurization induced a significant loss of this capacity that was more pronounced after high-temperature treatment than after low-temperature processing. Untreated milk, low-pasteurized milk, and high-pasteurized milk yielded a reduction in E. coli growth of 70.10%, 52.27%, and 36.39%, respectively. In conclusion, human milk possesses antimicrobial activity that is lost in part as a result of thermal processing. Such bactericidal capacity is, moreover, better preserved by low-temperature, long-time pasteurization.

Objective: Lyophilization appears to be a viable method for storing human milk, assuring no microbiological contamination and preserving its health benefits and antibacterial properties. The aim of the study is to evaluate and compare the effects of different storage methods (lyophilization and freezing at −20°C and −80°C) and maternal factors (gestational length or time postpartum) upon the microbiological contents and bactericidal activity of human milk. The possible relation between bactericidal activity and the content of certain nutrients and functional components is also investigated. Methods: Microbiological content, bactericidal activity, sialic acid, and ganglioside contents, as well as protein, fat, and lactose concentrations were assessed in 125 human milk samples from 65 healthy donors in the Human Milk Bank of La Fe (Valencia, Spain). Results: Lyophilization and storage at −80°C significantly reduced the content of mesophilic aerobic microorganisms and Staphylococcus epidermidis when compared with storage at −20°C. Bactericidal activity was not significantly modified by lyophilization when compared with freezing at either −20°C or −80°C. Bactericidal activity was not correlated with fat, protein, or lactose content, but was significantly correlated to ganglioside content. The bactericidal activity was significantly greater (P < 0.05) in mature milk and in milk from women with term delivery than in milk from early lactation (days 1–7 postpartum) and milk from women with preterm delivery, respectively. Conclusions: Lyophilization and storage at −80°C of human milk yields similar results and are superior to storage at −20C with regard to microbial and bactericidal capacities, being a feasible alternative for human milk banks.

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.

Background: Neonatal infections with Cronobacter sakazakii have recently been associated with the consumption of expressed human milk. Study Aims: (1) To evaluate whether human milk has antimicrobial capacity against C. sakazakii and (2) to determine the stability of its capacity when it is subjected to various treatments. Methods: The antimicrobial capacity of human milk against C. sakazakii was evaluated using an observational, cross-sectional, comparative design. Mature human milk samples (N = 29) were subjected to different treatments. After incubation at 37°C for 72 hr, samples were compared with fresh milk on the stability of their antimicrobial capacity. Two-way analysis of variance (ANOVA) was performed. Results: In fresh milk, counts of C. sakazakii were reduced by 47.26% (SD = 6.74) compared to controls. In treated milk, reductions were: refrigeration at 4°C for 72 hr (M = 33.84, SD = 13.84), freezing at –20°C for 1, 2, and 3 months (M = 40.31, SD = 9.10; M = 35.96, SD = 9.39; M = 26.20, SD = 13.55, respectively), Holder pasteurization (M = 23.56, SD = 15.61), and human milk bank treatment with (M = 14.37, SD = 18.02) and without bovine fortifier (M = 3.70, SD = 23.83). There were significant differences (p < .05) between fresh and treated milk. Conclusions: Human milk has antimicrobial capacity against C. sakazakii. However, its capacity is negatively influenced by common preservation and hygienization methods. Milk should be stored refrigerated for a maximum of 72 hr or frozen for a short period of time.

Milk supplied to neonates in neonatal units is kept at room temperature for some time, which could influence microbial growth. This study aims to evaluate the growth of Escherichia coli in HM and PIF under various treatments and conditions, as well as to determine the influence of different thawing methods on microbial growth in HM. The number of E. coli generations appearing over a 4 h period at 22 °C in HM (frozen; frozen and pasteurized; and frozen, pasteurized, and fortified) and in PIF (four brands) was determined. E. coli counts in HM inoculated and thawed using different methods were also compared. In frozen HM and in pasteurized and frozen HM, significant differences were found after 2.5 h and 1.5 h, respectively. In PIF, differences were found between 1.5 and 3 h. With regard to the thawing process, the lowest microorganism counts were obtained at 4 °C overnight; thus, it seems advisable to store milk at room temperature for a maximum of 1 h during administration in neonatal units. Thawing HM at 4 °C overnight should be the method of choice.