Alterations in the Host Defense Properties of Human Milk Following Prolonged Storage or Pasteurization

Division of Pulmonary Biology and Neonatology, Cincinnati Children's Hospital Medical Center,Cincinnati, OH, USA.
Journal of pediatric gastroenterology and nutrition (Impact Factor: 2.63). 09/2010; 51(3):347-52. DOI: 10.1097/MPG.0b013e3181e07f0a
Source: PubMed


Preterm infants are often fed pasteurized donor milk or mother's milk that has been stored frozen for up to 4 weeks. Our objectives were to assess the impact of pasteurization or prolonged storage at -20 degrees C on the immunologic components of human milk and the capability of the different forms of human milk to support bacterial proliferation.
The concentrations and activities of major host defense proteins in the whey fractions of mother's milk stored for 4 weeks at -20 degrees C or pasteurized human donor milk were compared with freshly expressed human milk. Proliferation of bacteria incubated in the 3 forms of human milk was assessed.
Relative to freshly expressed human milk, the concentrations of lysozyme, lactoferrin, lactoperoxidase, and secretory immunoglobulin A were reduced 50% to 82% in pasteurized donor milk and the activities of lysozyme and lactoperoxidase were 74% to 88% lower (P < 0.01). Proliferation of bacterial pathogens in pasteurized donor milk was enhanced 1.8- to 4.6-fold compared with fresh or frozen human milk (P < 0.01).
The immunomodulatory proteins in human milk are reduced by pasteurization and, to a lesser extent, by frozen storage, resulting in decreased antibacterial capability. Stringent procedure to minimize bacterial contamination is essential during handling of pasteurized milk.

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    • ") and enzymes (lysozyme, lactoperoxidase, lipoprotein lipase, bile salt stimulated lipase) (Akinbi et al., 2010; Henderson, Fay, & Hamosh, 1998). Besides these alterations, heat treatments together with freeze-thaw cycles of human milk can induce the disruption of the milk fat globules (Vieira et al., 2011; Wardell, Hill, & Dsouza, 1981), protein denaturation and some aggregation of proteins on the fat globule membrane (Raikos, 2010; Ye, Singh, Taylor, & Anema, 2004). "
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    ABSTRACT: When the mother's own humanmilk is unavailable or limited, pasteurized human milk from milk banks is preferentially administered instead of infant formula, especially for vulnerable hospitalized neonates. Holder pasteurization (62.5 °C, 30 min) may alter human milk composition and structure, which may modulate its digestive behavior. An in vitro dynamic systemwas set up to simulate the gastrointestinal digestion of termnewborns in order to compare the kinetics of lipolysis, proteolysis and structural disintegration of rawversus pasteurized humanmilk. Humanmilk from5 donorswas pooled. Half of the poolwas either administrated raw(RHM) or pasteurized (PHM). Digestionswere conducted at least in duplicate for RHMand PHM. Heat-induced protein aggregation was observed in PHM. During gastric digestion, β-casein was proteolyzed significantly faster for PHM than for RHM(p b 0.05),whereas lactoferrin tended to be proteolyzed slower (p=0.07) for PHM. Pasteurization selectively affected the intestinal release of some amino acids. At any time of the gastrointestinal digestion, the lipolysis of PHMwas significantly lower than that of RHM, but no impact was observed on the profile of released fatty acids. RHMpresented a structural destabilization after 60 min of gastric digestion, while therewas no large variation for PHM. In the intestinal phase, the evolution of the particle sizes was rather similar. Overall, Holder pasteurization impacted the proteolysis, lipolysis and disintegration of human milk. However, this impact was limited and the physiologic and metabolic consequences remain to be investigated.
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    • ") . Furthermore , Akinbi et al . ( 2010 ) docu - mented that effectiveness of the immune proper - ties of human milk is reduced with freezing and pasteurization , and the risk of bacterial prolifera - tion is increased ( Akinbi et al . ) ."
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