Breast Milk-Transmitted Cytomegalovirus Infection in Preterm Infants

PURPOSE: The purpose of this study is to describe the rate of cytomegalovirus (CMV) virolactia, and the prevalence of breast milk (BM)-transmitted postnatal CMV infection among premature infants after freeze-thawing (FT) and Holder pasteurization (HP) of breast milk. METHODS: This is a single-center, retrospective study of 312 infants born at less than 32 weeks of gestation, or with a birth weight less than 1,500 g from January 2013 to June 2017. All infants were screened for CMV-specific immunoglobulin (Ig) G and IgM at birth. Initial CMV specific polymerase chain reaction (PCR) and CMV culture were performed on mothers' BM and babies' urine within the first 21 days of life. FT and HP of BM was used to prevent the transmission of CMV. For the surveillance of postnatal CMV infection, CMV culture and CMV specific PCR of urine from babies were repeated one to two months after the initial screening. Screening for viremia and viruria was performed if postnatal CMV infection was suspected. RESULTS: Among 178 BM samples obtained from mothers of CMV-IgG-seropositive infants, 80 (44.9%) were CMV PCR positive. CMV deoxyribonucleic acid (DNA) was detected in five of the 22 BM samples (22.7%) obtained from the mothers of CMV-IgG seronegative infants. When CMV DNA load in BM was measured before and after HP, various results were shown. Sixty-three infants out of 232 (27.2%) were evaluated for postnatal CMV infection and four infants out of 63 (6.3%) were infected. CONCLUSION: Interventions to prevent BM-transmitted CMV infection can reduce the chance of postnatal CMV infection, but not completely eliminate it.

Influence factors of macronutrients and energy content of donor human milk / 实用医学杂志

Objectives To explore the effect of holder pasteurization, frozen storage time and thawing methods on macronutrients and energy content of donor human milk, and to provide theoretical basis for the rational use of breast milk. Methods Thirty-three samples of donor human milk were collected and an aliquot of each sample was analyzed before and after pasteurization. The remaining milk after pasteurization was split into 9 aliquot , and frozen at -20 ℃. After 30, 60, and 90 days, the milk was thawed by three different methods of room tempe-rature, 4 ℃ refrigeration, and 37 ℃ water bath, respectively. The nutrient components of each aliquot were analyzed and compared. Results We observed a mild reduction in fat and energy content after pasteurization (P <0.05). A significant decrease of fat, protein and energy content with the prolonged storage time was observed (P <0.01), and during the whole process (pasteurization + frozen storage), the decrease of fat, protein and energy content was 36.6%, 32.6%and 22.6%, respectively. The protein was influenced mostly by different thawing methods and the content of protein reached highest while thawed at 4 ℃ refrigeration. Conclusions Holder pasteurization and frozen storage at-20℃significantly reduce fat, protein and energy content of donor human milk. The donor milk should be used as quickly as possible when applied for preterm infants and thawing at 4 ℃ refrigeration is recommended before delivery to newborn infants.