Bertino Enrico, Peila Chiara, Cresi Francesco, Maggiora Elena, Sottemano Stefano, Gazzolo Diego, Arslanoglu Sertac, Coscia Alessandra
Neonatology Unit, Department of Public Health and Pediatrics, Università degli Studi di Torino, Turin, Italy.
Department of Maternal, Fetal and Neonatal Health, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Front Pediatr. 2018 Oct 5;6:253. doi: 10.3389/fped.2018.00253. eCollection 2018.
Mother's own milk is the first choice for the feeding and nutrition of preterm and term newborns. When mother's own milk is unavailable or in short supply donor human milk (DM) could represent a solution. Heat treatment and cold storage are common practices in Human Milk Banks (HMBs). Currently, Holder pasteurization process is the recommended heat treatment in all international guidelines. This method is thought to lead to a good compromise between the microbiological safety and nutritional/biological quality of DM. Moreover, storage of refrigerated milk is a common practice in HMBs and in NICUs. Depending on the length and on the type of storage, human milk may lose some important nutritional and functional properties. The available data on oxidative stress markers confirm that pasteurization and refrigeration affected this important elements to variable degrees, even though it is rather difficult to quantify the level of deterioration. Nonetheless, clinical practice demonstrates that many beneficial properties of human milk are preserved, even after cold storage and heat treatment. Future studies should be focused on the evaluation of new pasteurization techniques, in order to achieve a better compromise between biological quality and safety of DM.
母乳是早产和足月新生儿喂养与营养的首选。当无法获得或母乳供应不足时，捐赠人乳（DM）可能是一种解决方案。热处理和冷藏是母乳库（HMBs）的常见做法。目前，国际指南推荐采用低温长时间巴氏杀菌法进行热处理。该方法被认为能在DM的微生物安全性与营养/生物学质量之间达成良好平衡。此外，冷藏母乳在母乳库和新生儿重症监护病房（NICUs）中很常见。根据储存时间和储存类型的不同，人乳可能会失去一些重要的营养和功能特性。关于氧化应激标志物的现有数据证实，巴氏杀菌和冷藏对这些重要成分有不同程度的影响，尽管很难量化其变质程度。尽管如此，临床实践表明，即使经过冷藏和热处理，人乳的许多有益特性仍得以保留。未来的研究应侧重于评估新的巴氏杀菌技术，以便在DM的生物学质量和安全性之间取得更好的平衡。
