Hunan Milk Banking

Question 1

What are some benefits of breast milk?

Answer 1

Optimum growth
Immune function
Cost
Development

Question 2

What are some of the benefits of human milk for preterm babies?

Answer 2

Fewer severe infections 
Less NEC - evidence based 
Reduction in colonisation by pathogenic organism 
Improved neurodevelopmental outcomes 
Decreased length of hospital stay

Question 3

Other than preterm babies, which group of hospitalised babies also benefits from human milk?

Answer 3

Babies requiring GI surgery

Question 4

Are there any potential negative effects of human donor milk in preterm neonates?

Answer 4

A systematic review did find a slower growth in these infants, although there was significant variability if the feeding practices

Question 5

What infections are donors tested for?

Answer 5

HIV
Hepatitis C and B
Human T cell leukaemia virus

Question 6

Apart from texting for infections, what are the other safety measures?

Answer 6

All milk must be properly collected, stored, pasteurised, and cultures in accordance with food preparation guidelines as set out by the Canadian food inspection agency.

Question 7

How common are infections transmitted by donor milk?

Answer 7

With the current safety measures there has never been an infection

Question 8

What do mothers need to do prior to being able to donate milk?

Answer 8

Interview
Medical approval
Infections screening at 0 and Q6m

Question 9

Apart from infections, what are some other reasons mothers may be declined from donating?

Answer 9

Medications including OTC
Smoking
Alcohol

Question 10

What is the role of pasteurisation?

Answer 10

To inactivate bacterial and viral contaminants such as CMV

Question 11

Do we worry about spore-forming bacillus?

Answer 11

The spore forming bacillus survives routine holder pasteurisation but unlike cows milk this is s rate contaminant of human breast milk and is detectable from surveillance cultures

Question 12

Does pasteurisation change the nutritional components of human Breast milk?

Answer 12

At worst some are minimally altered 
CHOs, fats and salts are unchanged
13% of proteins are denatured 
Fat soluble vitamins are unchanged 
We have not studied all of the water soluble vitamins

Question 13

Does pasteurisation change the immune factors of breast milk?

Answer 13

All beneficial immune cells are inactivated.
IgA and IgG are decreased
Lactoferrin is reduced (binds iron that bacteria need)
Lysozyme enzymes are reduced (attack bacterial cell walls)

A reduction in cytokines - allows better activity of epidermal growth factor and increased growth of intestinal epithelial cells.

Question 14

Is human donor milk cost effective?

Answer 14

There is evidence to support the cost effectiveness of using donor human breast milk by reducing LOS, Sepsis and NEC