Abstract:

Mother’s own milk (MOM) is the first choice in preterm infant feeding, and when it is not available or is insufficient, donor human milk (DHM) is recommended. It has been shown that feeding preterm infants with human milk is less related to major morbidities, enhances feeding tolerance and prevents metabolic syndrome in childhood. As The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) states, specific guidelines for Human Milk Banks (HMB) are needed to guarantee the best possible compromise between microbiological safety and nutritional/biological quality of human milk (HM). Currently, Holder pasteurization (HoP: pasteurization process at 62.5-63°C for 30 minutes) is recommended by all international guidelines: this method inactivates bacterial and viral pathogens but it also affects some nutritional and biological properties of human milk. New methods to ameliorate the biological quality and safety of DHM are under investigation in the last years. High Pressure Processing (HPP) is a non- thermal process used in food industries: this technology inactivates pathogenic microorganisms by applying hydrostatic high pressure, however further researches are required before applying this technology in milk banking. Ultraviolet-C irradiation (UV-C) is another non-thermal method capable of reducing vegetative bacteria in human milk and it also seems to preserve higher levels of immunological proteins than HoP. High-temperature short-time pasteurization (HTST: flash pasteurization, 72°C for 5-15 seconds) currently is available only at industrial level, but it could represent an alternative to HoP seeming to maintain the protein profile and some of the key active components of DHM. Further researches are needed to define the optimal treatment of DHM.

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