Bench Research, Human Milk, and SARS-CoV-2.

Abstract

* Abbreviations: ACE2 — : angiotensin-converting enzyme 2 COVID-19 — : coronavirus disease 2019 SARS-CoV-2 — : severe acute respiratory syndrome coronavirus 2 In this issue of Pediatrics , Conzelmann et al1 examined whether Holder pasteurization of human milk, that is, heating to 62.5°C for 30 minutes, can inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the laboratory, the authors “spiked” 5 individual women’s expressed milk samples with 5 different SARS-CoV-2 isolates, conducted Holder pasteurization (to 63°C), and then assessed tissue culture infectious dose 50 by infecting susceptible cells and monitoring the cytopathic effect. Holder pasteurization effectively inactivated SARS-CoV-2, and additionally, they noted a 40.9% to 92.8% viral titer decrease in human milk as compared with the control medium, confirming human milk’s unique antiviral properties. This important study adds to the limited evidence that pasteurized donor human milk is safe,2 but placing it within the clinical context is key.3 Providers and parents should not leap to any of several possible unfounded conclusions: (1) that the milk of a mother who has SARS-CoV-2 infection will be infected, (2) that her milk must be expressed to be fed to her infant, or (3) that her milk should be Holder pasteurized before feeding. Although much remains to … Address correspondence to Lydia Furman, MD, Division of General Academic Pediatrics, Department of Pediatrics, University Hospitals Rainbow Babies and Children’s Hospital, 11100 Euclid Ave, Cleveland, OH 44106. E-mail: lydia.furman{at}uhhospitals.org