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Human milk pasteurization: benefits and risks

O’Connor, Deborah L.a,c; Ewaschuk, Julia B.d; Unger, Sharona,b,e

Current Opinion in Clinical Nutrition & Metabolic Care: May 2015 - Volume 18 - Issue 3 - p 269–275
doi: 10.1097/MCO.0000000000000160
PAEDIATRICS: Edited by Berthold V. Koletzko and Raanan Shamir

Purpose of review: Recent findings substantiate that the optimal method of nourishing preterm, very low birth weight infants (VLBW, born <1500 g) is through appropriately nutrient-enriched human milk, which is frequently provided as pasteurized donor milk. The availability of donor milk for VLBW infants during initial hospitalization continues to increase with the launch of new milk banks in North America. The majority of North American neonatal ICUs now have written policies governing the provision of donor milk. The purpose of this review is to summarize recent evidence regarding the risks and benefits of pasteurization of human milk and outcomes associated with its provision to VLBW preterm infants.

Recent findings: Studies investigating the impact of collection, storage and pasteurization on the bacteriostatic, immunologic and nutritional aspects of human milk continue to be published, generally revealing a partial, but not complete reduction in bioactivity. Risk of contamination of pasteurized donor human milk with pathogenic agents is mitigated through pasteurization. New pasteurization methods aiming to maintain the safety of pooled human milk while better preserving bioactivity are under investigation.

Summary: Provision of a human milk-derived diet to preterm VLBW infants is associated with improved outcomes.

aDepartment of Nutritional Sciences

bDepartment of Paediatrics and Neonatology, University of Toronto

cPhysiology and Experimental Medicine Program, The Hospital for Sick Children, Toronto

dDepartment of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton

eDepartment of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada

Correspondence to Dr Deborah L. O’Connor, Department of Nutritional Sciences, University of Toronto, Room 327, FitzGerald Building, 150 College Street, Toronto, ON M5S 3E2, Canada. Tel: +1 416 946 7366; e-mail: deborah.oconnor@utoronto.ca

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