Human Milk Banking–Facts and Issues to Resolve

Willemijn E Corpeleijn,Ineke Van Vliet,I Caroline Kruger,Johannes B Van Goudoever,Marijn J Vermeulen

doi:10.3390/nu2070762

Abstract

The number of human milk banks is increasing worldwide. Although the beneficial effects of feeding premature infants with their mother’s milk are well documented, less is known about the effects of feeding these infants with pasteurized donor milk. We propose a randomized trial comparing the effects of a 100% human milk-based diet (human milk supplemented with a human milk-derived fortifier) and a diet (partially) based on bovine milk. In theory, human milk has a beneficial effect on various aspects of human physiology, most of which become apparent after infancy. We therefore propose an extensive follow-up program that takes this aspect into consideration. Other issues concerning the practice of human milk banks need to be addressed as well as optimization of the feeding strategies for preterm infants.

Highlights

Worldwide human milk banks are re-emerging after closing in the mid-1980s due to the identification of human immunodeficiency virus (HIV) in breast milk
Given that formula is cheaper than processed donor milk and formula does not pose the risk of vertical transmission of infection, proof of the benefit of human donor milk is needed
Two meta-analyses have shown a reduction in the incidence of necrotizing enterocolitis (NEC) in low birth-weight infants that were fed donor milk compared to those fed with formula

Summary

Introduction

Worldwide human milk banks are re-emerging after closing in the mid-1980s due to the identification of human immunodeficiency virus (HIV) in breast milk. The aim of human milk banks is to provide safe donor milk to (premature) infants so that they can benefit from the advantages of human milk when their own mother is unable to provide milk. Pasteurized donor milk does not necessarily exert the same positive effects as raw milk from the mother. It can be argued that the sIgA found in donor milk are not as well tailored to the infant’s needs compared to those in the milk of the infant’s own mother. This difference might be important for children admitted to the Neonatal. Given that (preterm) formula is cheaper than processed donor milk and formula does not pose the (albeit theoretical) risk of vertical transmission of infection, proof of the benefit of human donor milk is needed

Evidence of the Benefits of Donor Milk

Studies to be Undertaken

Method of Pasteurization

Safety of the Milk

Method of Fortification