Abstract
Donor human milk (DHM) is recommended as the first alternative for preterm infants if their mother's own milk is not available or if the quantity is not sufficient. The most commonly used technique to eliminate microbial contaminants in DHM is holder pasteurization (HoP). However, the heating process during HoP partially destroys milk bioactive factors such as insulin. Therefore, innovative techniques have been developed as alternatives to HoP. The objective of this study was to determine the effect of HoP, high-temperature-short-time (HTST), thermoultrasonication (TUS), ultraviolet-C irradiation (UV-C), and high-pressure processing (HPP) on the insulin concentration in DHM. Milk samples from 28 non-diabetic mothers were collected. The milk samples were aliquoted and either left untreated or treated with HoP (62.5°C; 30min), HTST (72°C; 15s), TUS (60W; 6min), UV-C (4863J/L), or HPP (500MPa; 5min). The mean insulin concentration in untreated milk was 79±41pmol/L. The mean insulin retention rate was 67% for HoP, 78% for HTST, 97% for TUS, 94% for UV-C, and 106%for HPP. The mean insulin concentration in milk treated with HoP was significantly lower compared to untreated milk (p=0.01). TUS, UV-C, and HPP preserve insulin in DHM. The insulin concentration in DHM is affected to a larger extent by HoP than by HTST. These results indicate that TUS, UV-C, and HPP may serve as alternatives to HoP.
Highlights
Pasteurized donor human milk (DHM) is recommended as the first alternative for preterm infants if their mother's own milk is not available or if the quantity is not sufficient [1]
Samples with a retention rate that was within the range of agreement were as follows: 4 (14%) for holder pasteurization (HoP), 13 (46%) for HTST, (79%) for TUS, (82%) for ultraviolet-C irradiation (UV-C), and 21 (75%) for high-pressure processing (HPP)
A decreased milk insulin concentration was observed in 24 (86%) of the samples treated with HoP, 15 (54%) of the samples treated with HTST, 2 (7%) of the samples treated with TUS, and 5 (18%) of the samples treated with UV-C
Summary
Pasteurized donor human milk (DHM) is recommended as the first alternative for preterm infants if their mother's own milk is not available or if the quantity is not sufficient [1]. The currently recommended method is holder pasteurization (HoP), which includes heating the milk for 30 min at 62.5 C [2] This heating process partially destroys bioactive factors, thereby reducing the quality of DHM [2]. To improve the quality of DHM, innovative techniques, such as high-temperatureeshort-time (HTST), thermoultrasonication (TUS), ultraviolet-C irradiation (UV-C), and high-pressure processing (HPP) are currently under investigation as alternatives for HoP [2,3]. Higher retention rates of various nutritional and bioactive factors (e.g., immunological components and enzymes) were achieved using these techniques compared to HoP, while pathogens were still adequately inactivated [2,3] The effect of these innovative techniques on milk hormones, such as insulin, has rarely been investigated [2,3]. These results indicate that TUS, UV-C, and HPP may serve as alternatives to HoP
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