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      High Hydrostatic Pressure Processing Better Preserves the Nutrient and Bioactive Compound Composition of Human Donor Milk

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          ABSTRACT

          Background

          When mother's milk is insufficient, pasteurized human donor milk (DM) is the recommended supplement for hospitalized very-low-birth-weight infants. The current method of pasteurization (Holder, 62.5°C, 30 min) negatively affects heat-sensitive nutrients and bioactive proteins.

          Objectives

          Objectives of this study were to compare changes in DM composition after thermal pasteurization (Holder and flash-heating) and nonthermal methods [UV-C irradiation and high hydrostatic pressure (HHP)]. We hypothesized that nonthermal techniques would result in fewer changes to composition.

          Methods

          Holder, flash-heating (brought to boil), UV-C irradiation (250 nm, 25 min), and HHP (500 MPa, 8 min) were studied. Pools of milk from 17 women known to contain bacteria at >5 × 107 colony forming units (CFU)/L were collected from the Rogers Hixon Ontario Human Milk Bank and underwent each pasteurization technique. Macronutrients, heat-sensitive micronutrients (vitamin C, folate), and bioactive components [bile-salt-stimulated lipase (BSSL), lysozyme, lactoferrin] were measured in raw and pools of pasteurized milk. Milk was cultured to determine how well each technique produced a culture negative result (detection limit <1 × 103 CFU/L).

          Results

          Folate was reduced by 24–27% after Holder, flash-heating, and UV-C (P < 0.05); no reduction was observed after HHP. All pasteurization methods reduced vitamin C (60–75%, P < 0.001). BSSL was abolished after Holder and flash-heating (P < 0.001), reduced after UV-C (48%, P < 0.001), but unaffected by HHP. Lysozyme activity was reduced after flash-heating (44%) and UV-C (74%, P < 0.004) but unaffected by Holder or HHP. Lactoferrin was reduced by all methods (P < 0.02) but most severely by flash-heating (74%) and least severely by HHP (25%). Holder and UV-C reduced lactoferrin by ∼48%. All pasteurization methods reduced the number of culture positive DM samples (P < 0.001).

          Conclusions

          HHP better preserves human milk composition than Holder pasteurization. Future research on the feasibility of HHP for pasteurizing human milk is warranted because its implementation may improve the nutritional status and health of DM-fed infants.

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          Most cited references50

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          Human milk for the premature infant.

          Premature infants are at risk for growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis. Human milk from women delivering prematurely has more protein and higher levels of bioactive molecules. Human milk must be fortified for premature infants to achieve adequate growth. Mother's own milk improves growth and neurodevelopment, decreases the risk of necrotizing enterocolitis and late-onset sepsis, and should be the primary enteral diet for premature infants. Donor milk is a resource for premature infants whose mothers are unable to provide an adequate supply of milk. Challenges include the need for pasteurization, nutritional and biochemical deficiencies, and limited supply. Copyright © 2013 Elsevier Inc. All rights reserved.
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            The measurement of lysozyme activity and the ultra-violet inactivation of lysozyme.

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              Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial.

              For many very low-birth-weight (VLBW) infants, there is insufficient mother's milk, and a supplement of pasteurized donor human milk or preterm formula is required. Awareness of the benefits of mother's milk has led to an increase in use of donor milk, despite limited data evaluating its efficacy.
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                Author and article information

                Journal
                The Journal of Nutrition
                Oxford University Press (OUP)
                0022-3166
                1541-6100
                March 2019
                March 01 2019
                February 15 2019
                March 2019
                March 01 2019
                February 15 2019
                : 149
                : 3
                : 497-504
                Affiliations
                [1 ]Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
                [2 ]Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
                [3 ]Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
                [4 ]Department of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
                [5 ]Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
                [6 ]Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Ontario, Canada
                [7 ]Département des Sciences des Aliments et de Nutrition, Institut sur la nutrition et les aliments fonctionnels, Centre de recherche STELA, Université Laval, Québec, Québec, Canada
                [8 ]Evaluative Clinical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
                [9 ]Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
                Article
                10.1093/jn/nxy302
                6398389
                30770541
                983856fb-d8ad-4c2c-97ae-84ebea837e62
                © 2019

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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