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Bacterial Content of Fortified and Unfortified Holder Pasteurized Donor Human Milk during Prolonged Refrigerated Storage

Mandru, Cosmina*; Perrin, Maryanne T.; Iyer, Radha; Liveris, Dionysios; Schwartz, Ira; Alpan, Gad*; Parvez, Boriana*

Journal of Pediatric Gastroenterology and Nutrition: June 20, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002427
Original Article: PDF Only
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Objective: To assess the microbial growth in unfortified and fortified Holder pasteurized donor human milk (HPDHM) during 96 hours of refrigerated storage in a clinical setting.

Methods: Thirty-six unfortified samples and 77 fortified samples of HPDHM were prepared in a neonatal intensive care milk preparation room and stored in the NICU refrigerator at 4°C to simulate a real-life feeding environment. 1 mL aliquots were removed at 24 hour intervals and cultured in duplicate for bacterial growth on solid blood agar medium. Viable bacterial colonies were characterized using standard microbiological methods.

Results: 96.5% of milk samples manipulated in a vertical laminar flow hood were negative for bacterial growth. In the remainder 3.5% of the samples the maximum growth was 1 colony forming unit/ 0.1 ml plated. Higher colony counts were observed when the laminar hood was not used. In all cases, the colonies represented common skin bacteria and demonstrated an inconsistent and unsustained growth. Fortifier status and storage time were not significantly associated with increased bacterial growth (P > 0.05).

Conclusions: Unfortified and fortified Holder pasteurized donor human milk remain largely free of bacterial growth for up to 96 hours of refrigerated storage in NICU settings. Sample handling techniques are important for preventing microbial contamination.

*The Regional Perinatal Center, Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY

Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina

Department of Microbiology, New York Medical College, Valhalla, NY.

Address correspondence and reprint requests to Boriana Parvez, Division of Neonatology, MFCH, 100 Woods Road, Valhalla, NY, 10595 (e-mail: boriana.parvez@wmchealth.org).

Funding source: This study was supported in part by a Designated Research Fund of Boriana Parvez

Conflicts of Interest and Sources of Funding: MTP serves on the Board of Directors for the Human Milk Banking Association of North America in an unpaid capacity. BP serves on the Research Committee of the Human Milk Banking Association of North America in an unpaid capacity and on the Board of Directors of The New York Milk Bank

Abbreviations: BOV – bovine-derived fortifier; BSL – biosafety level; CFU – colony forming unit; HMBANA – Human Milk Banking Association of North America; HPDHM – Holder pasteurized donor human milk; HUM – human-derived fortifier; NICU – neonatal intensive care unit; VLBW – very low birth weight;

AUTHOR CONTRIBUTIONS: CM conceptualized and designed the study, collected and analyzed data, and drafted the initial manuscript. MTP analyzed the data and drafted the initial manuscript. RI conceptualized and designed the study and reviewed the manuscript. DL conceptualized and designed the study, provided study supervision, and reviewed the manuscript. IS conceptualized the study and reviewed the manuscript. GA conceptualized and designed the study, collected and analyzed data, and reviewed the manuscript. BP conceptualized and designed the study, collected and analyzed data, provided study supervision, and drafted the initial manuscript. All authors gave final approval of the manuscript.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,