Human milk banking

Question 1

What are the benefits of human breast milk for preterm infants?

Answer 1

1. Reduced severe infections
2. Reduced NEC
3. Reduced colonization by pathogenic organisms
4. Decreased LOS
5. Improved neurodevelopmental outcomes

Question 2

What percentage of infants in Canada are born premature?

Answer 2

~7%

Question 3

What are safety considerations regarding donor breast milk?

Answer 3

1. Interview to ensure do not smoke, take medications, or drink
2. Serological screening for hepatitis B, C, HIV, human T cell leukemia virus
3. All milk must be properly collected, stored, pasteurized and cultured
4. Requires written parental consent

Question 4

What are the effects of pasteurization?

Answer 4

1. Inactivates bacterial and viral contaminants excld. spore forming bacillus species
2. Carbohydrates, fats, and salts are unchanged
3. 13% of proteins are denatured
4. Fat soluble vitamins are unchanged
5. Some degradation of water soluble vitamins
6. 67% activity of IgA
7. 66-70% IgG
8. Removal of IgM
9. 20% of Lactoferrin
10. 75% activity of lysozyme enzyme
11. Reduction in cytokines

Question 5

What are the CPS recommendations regarding human milk banking?

Answer 5

1. The preferred nutrition for the newborn is his/her own mother’s milk. When this is not available or is limited, pasteurized human donor breast milk is a recommended alternative for hospitalized neonates.
2. The use of pasteurized human donor breast milk should be prioritized to compromised preterm infants and selected ill term newborns.
3. Pasteurized human donor breast milk should only be prescribed following written informed consent from a parent or guardian.
4. Education of parents about the benefits of human breast milk or pasteurized human donor breast milk is essential to parental choice and informed decision making in prescribing an optimal feeding plan for hospitalized neonates.
5. Milk banking should be adopted as a cost-effective nutritional source for hospitalized neonates because it reduces disease incidence and severity, thus reducing resource use during the hospitalization.
6. Recognized functions of the human milk bank should include the promotion of breastfeeding and ongoing human milk research.
7. There is a need for prospective studies to evaluate the benefits of banked human breast milk in preterm infants in the NICU.
8. The Canadian Paediatric Society does not endorse the sharing of unprocessed human milk.