Comparison of two methods for cleaning breast pump milk collection kits in human milk banks.

BACKGROUND: Appropriate decontamination of breast pump milk collection kits (BPKs) is critical to obtain safe milk for infants and to avoid discarding donor human milk (DHM). AIM: To evaluate two strategies for BPK decontamination by assessing microbial cultures and the proportion of discarded DHM, according to the criteria of the National Institute for Health and Care Excellence for pre-pasteurization cultures. METHODS: Prospective comparative study, allocation ratio 1:1, microbiologist-blind. PARTICIPANTS: 47 new donors in a human milk bank in Madrid. INTERVENTIONS: Study group (N=21): BPKs washed with water and detergent after each use and further steam decontamination within a microwavable bag. Control group (N=26): washing, rinsing and drying only. Five samples: first sample by hand expression and four samples (one per week) collected using the same pump and method. OUTCOMES: Primary: proportion of DHM discarded due to contamination. Secondary: comparison of the microbiota between samples obtained by hand expression and breast pump in both groups. FINDINGS: In total, 217 milk samples were collected: 47 by hand expression and 170 by pump expression (78 from study group). Steam decontamination of BPKs using a microwavable bag after washing resulted in a lower proportion of discarded DHM samples (1.3% vs 18.5%, P<0.001) and samples contaminated with Enterobacteriaceae (1.3% vs 22.8%, P<0.001) and Candida spp. (1.3% vs 14.1%, P<0.05) compared with samples collected with BPKs that were washed but not steam decontaminated. There were no differences in bacterial contamination between samples obtained using steam decontaminated BPKs and those obtained by hand expression. CONCLUSIONS: Steam decontamination of BPKs using a microwavable bag after washing decreases the amount of discarded DHM and the number of samples with potentially pathogenic bacteria.

Short communication: Effect of refrigerated storage on the pH and bacterial content of pasteurized human donor milk.

Once pasteurized donor milk is thawed for its administration to a preterm or sick neonate, and until it is administered, it is kept refrigerated at 4 to 6°C for 24 h. After this time, unconsumed milk is discarded. This time has not been extended, primarily because of the concern of bacterial contamination. The aim of this study was to determine the changes in pH and bacterial count when pasteurized donor milk was kept under refrigeration for a prolonged period (14 d). In this prospective study, 30 samples of pasteurized donor milk from 18 donors were analyzed. Milk was handled following the regular operating protocols established in the neonatal unit and was kept refrigerated after thawing. pH measurements and bacteriology (on blood agar and MacConkey agar plates) were performed on each sample at time 0 (immediately after thawing) and then every day for 14 d. Changes in pH of samples over time were evaluated with linear mixed-effects regression models. A slow but gradual increase in milk pH was observed starting from the first day [mean (±SD) pH of 7.30 (±0.18) at time 0 and 7.69 (±0.2) on d 14]. No bacterial growth was observed in any of the samples throughout the complete trial except in one sample, in which Bacillus flexus was isolated. In conclusion, pasteurized human donor milk maintains its microbiological quality when properly handled and refrigerated (4-6°C). The slight and continuous increase in milk pH after the first day could be due to changes in the solubility of calcium and phosphate during refrigerated storage.

Medida por crematocrito del contenido calórico de la leche materna donada congelada / Effect of freezing on the "creamatocrit" measurement of the lipid content of human donor milk

OBJETIVO: Determinar, mediante crematocrito, las modificaciones del contenido graso de la leche materna cruda y pasteurizada a lo largo de 3 meses de congelación. MÉTODO: Se analizó la evolución del crematocrito (fórmula de Lucas) en leche cruda y pasteurizada a lo largo de 3 meses de congelación a −20°C. RESULTADOS: La grasa en leche cruda (n=44) fue 3,19g/dl al inicio y 2,86g/dl a los 3meses de congelación (p = 0,02). En leche pasteurizada (n=36), al inicio fue 2,59g/dl y 2,20g/dl al mes de congelación (p = 0,01), posteriormente, hasta los 3 meses, no hubo cambios significativos. Se observó variabilidad en los valores intermedios. CONCLUSIONES: Se observó una disminución en la medida de la grasa tras congelación en leche cruda y pasteurizada. La congelación no impide la acción de la lipasa y también afecta al glóbulo de grasa. Probablemente, el crematocrito no sea el método óptimo para cuantificar la grasa en leche ya procesada

OBJECTIVE: To determine, by the creamatocrit measurement, the effect on the fat content of raw and pasteurized donor milk of freezing during 3 months at −20 °C. METHODS: The evolution of the creamatocrit measurement (following Lucas technique) on frozen (−20 °C), raw and pasteurized human milk, was analyzed during 3 months. RESULTS: The fat content of raw milk (n=44) was 3.19 g/dl at the beginning and 2.86 g/dl after 3 months frozen (p = 0.02). In pasteurized milk (n=36) fat content at the first determination was 2.59 g/dl and 2.20 g/dl after 1 month frozen (p = 0.01). Afterwards there were no significant changes up to 3 months frozen. Variability was observed in the intermediate values. CONCLUSIONS: A reduction on the fat content measurement of raw and pasteurized donor human milk after freezing was observed. Freezing does not inactivate the milk lipase but does destroy the fat globule. Creamatocrit measurement may not be the best method to determine the fat content of processed human milk

Características de las mujeres donantes de un banco de leche materna y relación con el tiempo de donación / Profile of human milk bank donors and relationship with the length of the donation

INTRODUCCIÓN: Promocionar los bancos de leche materna es una importante labor social y sanitaria. Los bancos dependen de las donaciones de madres lactantes, por ello la importancia de conocer las características de las donantes. OBJETIVOS: Describir las características demográficas de las donantes, proporcionar información sobre los factores que les influyen o motivan y relacionar sus características con el tiempo de donación. MÉTODOS: Estudio descriptivo prospectivo; 168 donantes cumplimentaron un cuestionaron escrito cuando iniciaron la donación. A 98 (58%) de ellas se les pasó una entrevista telefónica. RESULTADOS: La edad media fue 33,1 ± 4,5 años. El 27,9% vivía fuera de Madrid y un 21,4% eran inmigrantes. El 23,7% tenía un empleo a jornada completa, el 65,3% formación universitaria y el 96,2% pareja estable. La principal razón para donar fue exceso de leche (77%) y querer ayudar a otras mujeres (75%). El 20% identificó el transporte de la leche hasta el banco como el principal obstáculo. Para el 61%, la principal razón para terminar la donación fue el final de la lactancia. Se asocia a mayor tiempo de donación tener un hijo a término, con peso mayor de 1.500 g, empezar pronto la donación y compatibilizar la donación con la situación laboral. CONCLUSIÓN: El perfil más común de donante es una mujer joven, universitaria y con pareja estable. El tener un recién nacido a término, iniciar antes la donación y compatibilizar la situación laboral con la donación incrementan el tiempo de donación. Recoger la leche en el domicilio facilitaría la donación a las mujeres

INTRODUCTION: The promotion of Human Milk Banks is an important social service. The Human Milk Banks depend on donors, and knowing the profile of donors seems quite important. OBJECTIVE: To study the demographics and lifestyles of the donors, the reasons or influences for donating, and to associate these variables with the length of the donation. METHODS: This is a descriptive, cross-sectional study conducted on 168 mothers who answered the written questionnaire when they agreed to become donors. 98 (58%) responded to the telephone interview. RESULTS: The mean age was 33.1±4.5 years. Of the total 27.9% lived outside Madrid and 21.4% were immigrants, with 23.7% working full time, 65.3% had a university education, and 96.2% had a stable partner. The main reasons for donating were too much milk (77%), and to help others (75%). The main obstacle was transportation to the Human Milk Bank for 20% of the donors, and for 61% the main reason for terminating donation was due to reaching the end of lactation. A longer donation is associated with: having a term newborn, with birth weight over 1500g, starting donating early and reconciling the donation to the work situation. CONCLUSION: The most common donor profile was a young woman, with university education and a stable partner. Having a term new born, starting donating early, and the conciliation with work is associated with longer donations. Milk pick-up at home would make donation easier

[Profile of human milk bank donors and relationship with the length of the donation]. / Características de las mujeres donantes de un banco de leche materna y relación con el tiempo de donación.

INTRODUCTION: The promotion of Human Milk Banks is an important social service. The Human Milk Banks depend on donors, and knowing the profile of donors seems quite important. OBJECTIVE: To study the demographics and lifestyles of the donors, the reasons or influences for donating, and to associate these variables with the length of the donation. METHODS: This is a descriptive, cross-sectional study conducted on 168 mothers who answered the written questionnaire when they agreed to become donors. 98 (58%) responded to the telephone interview. RESULTS: The mean age was 33.1 ± 4.5 years. Of the total 27.9% lived outside Madrid and 21.4% were immigrants, with 23.7% working full time, 65.3% had a university education, and 96.2% had a stable partner. The main reasons for donating were too much milk (77%), and to help others (75%). The main obstacle was transportation to the Human Milk Bank for 20% of the donors, and for 61% the main reason for terminating donation was due to reaching the end of lactation. A longer donation is associated with: having a term newborn, with birth weight over 1500 g, starting donating early and reconciling the donation to the work situation. CONCLUSION: The most common donor profile was a young woman, with university education and a stable partner. Having a term new born, starting donating early, and the conciliation with work is associated with longer donations. Milk pick-up at home would make donation easier.

[Effect of freezing on the "creamatocrit" measurement of the lipid content of human donor milk]. / Medida por crematocrito del contenido calórico de la leche materna donada congelada.

OBJECTIVE: To determine, by the creamatocrit measurement, the effect on the fat content of raw and pasteurized donor milk of freezing during 3 months at -20 °C. METHODS: The evolution of the creamatocrit measurement (following Lucas technique) on frozen (-20 °C), raw and pasteurized human milk, was analyzed during 3 months. RESULTS: The fat content of raw milk (n=44) was 3.19 g/dl at the beginning and 2.86 g/dl after 3 months frozen (p=0.02). In pasteurized milk (n=36) fat content at the first determination was 2.59 g/dl and 2.20 g/dl after 1 month frozen (p=0.01). Afterwards there were no significant changes up to 3 months frozen. Variability was observed in the intermediate values. CONCLUSIONS: A reduction on the fat content measurement of raw and pasteurized donor human milk after freezing was observed. Freezing does not inactivate the milk lipase but does destroy the fat globule. Creamatocrit measurement may not be the best method to determine the fat content of processed human milk.