Second year Fellow Ramathibodi Hospital, Mahidol university Mahidol University Faculty of Medicine Ramathibodi Hospital Muang, Thailand
Background: WHO and AAP recommend donor human milk (DHM) which dispersed by Human Milk Bank for any preterm babies when mother’s own milk is not available. However, due to the complexity in DHM production with Holder technique (HoP), a standard method for pasteurization, establishing a human milk bank in the hospital involves a lot of expenses. Modified High-Temperature Short-Time (mHTST) pasteurization may be an alternative method with several benefit in hospitals with limited resources.
Objective: To develop a novel pasteurization, modified high-temperature short-time, and compare the effects on macronutrients and biofunctionalities to those of Holder pasteurization.
Design/Methods: The first phase in developing mHTST technique using flash heating in boiling water and rapid cooling down in iced water was performed to determine the appropriate milk container and lifting temperature to maintain the targeted temperature at 72oC for 15-20 seconds. The second phase study was conducted using 10 pools of DHM which was divided into 3 groups (raw milk before pasteurization, and milk after Holder and mHTST pasteurization). Each group was examined for macronutrients, lactoferrin, milk culture, bacterial inhibiting activity against E.coli and S.aureus and sterilized ability by milk culture after inoculating a large number of E.coli.
Results: mHTST technique using DHM at initial temperature of 4-8oC was feasible to reach and maintain in target temperature 72oC for 18+1.85 sec with the mean total immersed time of 3.28+0.10 min. Post-mHTST milk preserved protein, lipid, carbohydrate and energy similar to HoP. Lactoferrin levels were significantly lower in both HoP and mHTST than that of raw milk before pasteurization (0.49 and 0.33 vs. 2.25 mg/mL, respectively). All bacterial cultures were negative after HoP and mHTST. The bacterial inhibiting activity against E.coli after mHTST method was similar to HoP, however, those activities against S.aureus was better in mHTST compared to HoP. In addition, cultures of DHM adding a large number of E.coli up to 2x108 CFU/mL were negative after mHTST pasteurization. Conclusion(s): mHTST technique used in our study is feasible to meet target temperature and able to preserve macronutrients and antimicrobial activity like standard HoP. It should be considered as an alternative method for DHM pasteurization in resource-limited hospitals.
Equipments of modified high-temperature short-time pasteurization
mHTST pasteurization graph from the temperature recorder
Effects of pasteurization on macronutrients and lactoferrin
Effects of pasteurization on bacterial inhibiting activities
Authors/Institutions: Pasinee -. Kanaprach, Mahidol University Faculty of Medicine Ramathibodi Hospital, Muang, Nakhonpathom, Thailand; Pracha Nuntnarumit, Mahidol University Faculty of Medicine Ramathibodi Hospital, Muang, Nakhonpathom, Thailand