Donor Human Milk Banking and the Emergence of Milk Sharing

Pediatrix Medical Group, 1301 Concord Terrace, Sunrise, FL 33323, USA
Pediatric Clinics of North America (Impact Factor: 2.12). 02/2013; 60(1):247-60. DOI: 10.1016/j.pcl.2012.09.009
Source: PubMed


Donor human milk has emerged as the preferred substrate to feed extremely preterm infants, when mother's own milk is unavailable. This article summarizes the clinical data demonstrating the safety, efficacy, and cost-effectiveness of feeding donor human milk to premature babies. It describes the current state of milk banking in North America, as well as other parts of the world, and the differing criteria for donor selection, current pasteurization techniques, and quality control measures. A risk assessment methodology is proposed, which would allow milk banks globally to assess the safety of their process and respond appropriately to differing risk environments.

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    • "These depots have been replaced with milk banks, formal organisations that collect milk from screened donors, pasteurise it, and distribute it for a fee to babies for whom doctors have prescribed it as supplementary feeding (Hoodbhoy, 2013; Updegrove, 2013; Woo & Spatz, 2007). There are 16 Human Milk Bank Association of North America – affiliated non-profit milk banks in the US and Canada (Updegrove, 2013) and one for-profit bank that formulates milk for critically ill or premature infants (Landers & Hartmann, 2013). 2 S.K. Carter et al. "
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    ABSTRACT: The exchange of human breast milk, a common and well-established practice, has become a site of public controversy in the US. There is controversy over the use of the internet to facilitate milk exchange and public interest in the practice has been stimulated by a research article published in the journal Pediatrics that identified high levels of potentially harmful bacteria in breast milk sold online. In this article we use feminist critical discourse analysis to critically examine how breast milk sharing is represented in a sample of 30 articles from US print newspapers published in 2010–2013. We found complex and contradictory images of human milk, with medically supervised milk banks represented as a life-saving entity, nature’s ‘liquid gold’, whereas peer sharing of breast milk was represented as dangerous, and in this context breast milk was represented as a potentially life-threatening substance. Women who donated milk to milk banks were represented as altruistic and those who obtained their babies’ milk from the milk bank were represented as responsible and acting in the best interests of their babies. In contrast women who participated in peer milk sharing were represented at best as ill-informed about the risks to babies and at worst, morally reprehensible for disregarding the risks. Mothers who fed their babies this milk were represented as irresponsible and playing ‘Russian roulette’ with their babies. We argue that such contradictory representations are grounded in concerns in high income countries such as the USA with the control and surveillance of the female body through discourses of risk and are based on cultural constructions of individualism and intensive mothering.
    Health Risk & Society 01/2015; online first(1). DOI:10.1080/13698575.2014.1000269 · 1.13 Impact Factor
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    ABSTRACT: In the United States, concerns over the transmission of infectious diseases have led to donor human milk generally being subjected to pasteurization prior to distribution and use. The standard method used by North American milk banks is Holder pasteurization (63 degrees C for 30 minutes). The authors undertook an experiment to validate the effects of a high-temperature short-time (HTST) pasteurization process (72 degrees C for 16 seconds) on the bioburden of human milk. It was concluded that HTST is effective in the elimination of bacteria as well as of certain important pathogenic viruses.
    Breastfeeding Medicine 04/2007; 2(1):27-33. DOI:10.1089/bfm.2006.0015 · 1.25 Impact Factor
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    ABSTRACT: Holder pasteurization renders donor human milk safe for consumption. Because human milk reduces the risk of necrotizing enterocolitis in preterm infants, we tested whether Holder pasteurization affects certain factors in human milk that protect the intestines: epidermal growth factor (EGF), transforming growth factor (TGF)-beta1, erythropoietin (EPO), and interleukin (IL)-10. Donor human milk from a milk bank was examined. The aqueous phase of 17 samples of donor term human milk (mean duration of lactation, 8 +/- 3.5 months) was examined before and after Holder pasteurization. In the case of IL-10, lesser degrees of pasteurization were also evaluated. The agents were quantified using enzyme immunoassays. The function of IL-10 was also tested. Concentrations of EGF and IL-10 were markedly lower than previously reported values in human milk from earlier phases of lactation. Holder pasteurization significantly reduced the concentrations of EPO and IL-10, whereas lesser degrees of heating increased the detection of IL-10. The immunosuppression of T-cell proliferation by human milk, thought to be attributed to IL-10 alone, persisted after Holder pasteurization. Holder pasteurization greatly decreased concentrations of EPO and IL-10 in human milk. These decreases may impact the ability of human milk to protect against necrotizing enterocolitis. Evidence of possible binding of IL-10 to other proteins in human milk was also found. Experiments to test whether Holder pasteurization affects the function of IL-10 in human milk produced evidence for an agent in human milk other than IL-10 that inhibits T-cell proliferation and resists Holder pasteurization.
    Breastfeeding Medicine 05/2009; 4(3):137-44. DOI:10.1089/bfm.2008.0145 · 1.25 Impact Factor
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