Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA.
Division of Allergy and Immunology, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Breastfeed Med. 2021 Jan;16(1):29-38. doi: 10.1089/bfm.2020.0296. Epub 2020 Dec 30.
In addition to providing life-giving nutrients and other substances to the breastfed infant, human milk can also represent a vehicle of pathogen transfer. As such, when an infectious disease outbreak, epidemic, or pandemic occurs-particularly when it is associated with a novel pathogen-the question will naturally arise as to whether the pathogen can be transmitted through breastfeeding. Until high-quality data are generated to answer this question, abandonment of breastfeeding due to uncertainty can result. The COVID-19 pandemic, which was in full swing at the time this document was written, is an excellent example of this scenario. During these times of uncertainty, it is critical for investigators conducting research to assess the possible transmission of pathogens through milk, whether by transfer through the mammary gland or contamination from respiratory droplets, skin, breast pumps, and milk containers, and/or close contact between mother and infant. To promote the most rigorous science, it is critical to outline optimal methods for milk collection, handling, storage, and analysis in these situations, and investigators should openly share their methods in published materials. Otherwise, the risks of inconsistent test results from preanalytical and analytical variation, false positives, and false negatives are unacceptably high and the ability to provide public health guidance poor. In this study, we provide "best practices" for collecting human milk samples for COVID-19 research with the intention that this will also be a useful guide for future pandemics.
除了为母乳喂养的婴儿提供生命所需的营养和其他物质外，人乳还可能成为病原体传播的载体。因此，当传染病爆发、流行或大流行时——特别是当它与新病原体有关时——自然会出现这样的问题，即病原体是否可以通过母乳喂养传播。在获得高质量数据回答这个问题之前，由于不确定性而放弃母乳喂养可能会导致这种情况发生。在撰写本文时，COVID-19 大流行就是这种情况的一个极好例子。在这些不确定的时期，对于进行研究以评估病原体是否可能通过乳汁传播的研究人员来说，至关重要的是，无论是通过乳腺转移还是来自呼吸道飞沫、皮肤、吸乳器和奶容器的污染，以及/或母亲和婴儿之间的密切接触。为了促进最严格的科学，关键是要在这些情况下概述最佳的乳汁收集、处理、储存和分析方法，研究人员应在已发表的材料中公开分享他们的方法。否则，分析前和分析变化、假阳性和假阴性导致的不一致测试结果的风险过高，提供公共卫生指导的能力也很差。在这项研究中，我们提供了 COVID-19 研究中收集人乳样本的“最佳实践”，我们希望这也将成为未来大流行的有用指南。
