Peila Chiara, Emmerik Nikki E, Giribaldi Marzia, Stahl Bernd, Ruitenberg Joost E, van Elburg Ruurd M, Moro Guido E, Bertino Enrico, Coscia Alessandra, Cavallarin Laura
*Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, Turin University, Turin, Italy †Nutricia Research, Utrecht, The Netherlands ‡Institute of Sciences of Food Production, National Research Council (CNR), Grugliasco §Food & Nutrition Research Center, Council for Agricultural Research and Economics (CREA), Rome, Italy ||Faculty of Earth and Life Sciences-Free University (VU) of Amsterdam, Amsterdam ¶Emma Children's Hospital-Academic Medical Centre (AMC), Amsterdam, The Netherlands #Italian Association of Human Milk Banks (AIBLUD), Milan, Italy.
J Pediatr Gastroenterol Nutr. 2017 Mar;64(3):353-361. doi: 10.1097/MPG.0000000000001435.
Pasteurization, performed at 62.5°C for 30 minutes (holder pasteurization), is currently recommended in all international human milk banks guidelines, but it affects some human milk bioactive and nutritive components. The present systematic review is aimed at critically reviewing evidence on the suitability of human milk processing techniques other than holder pasteurization, both thermal and nonthermal, to ensure microbiological safety, and on the effects of these techniques on biologically active donor milk components. A systematic review of English and non-English articles using Medline, PubMed, Embase, SCOPUS, and CAB Abstracts, with no restriction in publication date was performed. Search terms included: human, breast, donor, or banked milk, breastmilk, breast fed, breastfed, breastfeed; HTST, Flash, High Pressure, UV, ultrasonic or nonthermal; process, pasteuris, pasteuriz. Only primary research articles published in peer-reviewed journals were included, providing or not a comparison with holder pasteurized human milk, provided that the pasteurization technique was clearly described, and not intended for domestic use. Additional studies were identified by searching bibliographies of relevant articles. Twenty-six studies were identified as being relevant. Two examined both High Pressure Processing and High-Temperature-Short-Time pasteurization; 10 only examined High Pressure Processing; 10 only examined High-Temperature-Short-Time; 2 articles examined ultraviolet irradiation; 2 articles examined (thermo-)ultrasonic processing. The results indicate that data about safety for microbiological control are still scarce for most of the novel technologies, and that consensus on processing conditions is necessary for nonthermal technologies, before any conclusions on the qualitative and nutritional advantages of these techniques can be drawn.
目前，所有国际母乳库指南都推荐采用在62.5°C下保持30分钟的巴氏杀菌法（保持式巴氏杀菌），但这种方法会影响母乳中的一些生物活性和营养成分。本系统综述旨在严格审查除保持式巴氏杀菌以外的其他母乳加工技术（包括热加工和非热加工）在确保微生物安全性方面的证据，以及这些技术对母乳中生物活性成分的影响。我们使用Medline、PubMed、Embase、SCOPUS和CAB文摘对英文和非英文文章进行了系统综述，对发表日期没有限制。检索词包括：人乳、母乳、捐赠母乳、母乳库母乳、母乳喂养、母乳哺育、母乳喂食；高温短时杀菌、闪蒸、高压、紫外线、超声波或非热；加工、巴氏杀菌、巴氏消毒。仅纳入发表在同行评审期刊上的原创研究文章，无论是否与保持式巴氏杀菌人乳进行了比较，前提是巴氏杀菌技术有清晰描述且非用于家庭用途。通过检索相关文章的参考文献确定了其他研究。共确定26项相关研究。其中2项研究同时考察了高压处理和高温短时巴氏杀菌；10项仅考察了高压处理；10项仅考察了高温短时杀菌；2篇文章考察了紫外线照射；2篇文章考察了（热）超声波处理。结果表明，对于大多数新技术而言，微生物控制安全性的数据仍然匮乏，并且在能够就这些技术的质量和营养优势得出任何结论之前，非热技术的加工条件需要达成共识。
