Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Pediatr Int. 2024 Jan-Dec;66(1):e15728. doi: 10.1111/ped.15728.
Human milk (HM) has been proven to provide immunological and nutritional advantages to neonates; however, acquired cytomegalovirus (CMV) infection can be associated with raw HM. In Japan, there are no standardized guidelines concerning HM handling. This cross-sectional survey was performed to reveal specific trends in HM handling in neonatal intensive care units (NICUs) in Japan.
A questionnaire was sent to 255 NICUs participating in the Japanese Neonatologist Association in May 2020. It involved HM handling practices, such as maternal screening, pasteurization, storage, and the workforce.
Of 255 NICUs, 174 (67.8%) responded to the survey. Maternal CMV screening was carried out in 37 units (22.2%), and CMV inactivation in HM was performed in 44 units (26.5%). For CMV inactivation, a freeze-thawing method was employed in about 90% of units. In 70% of units providing CMV inactivation, CMV inactivation was conducted regardless of bodyweight and corrected gestational age of infants until the infants' discharge. Acquired CMV infection in preterm neonates was observed in 43 units (25.7%) in the survey period.
A wide range of HM handling practices are used in Japanese NICUs. A national guideline for handling HM in NICUs should be created to promote the infection control of CMV.
人乳（HM）已被证明可为新生儿提供免疫和营养优势；然而，获得性巨细胞病毒（CMV）感染可能与未经处理的 HM 有关。在日本，没有关于 HM 处理的标准化指南。本横断面调查旨在揭示日本新生儿重症监护病房（NICU）中 HM 处理的特定趋势。
2020 年 5 月，向参与日本新生儿科医师协会的 255 个 NICU 发送了一份问卷。它涉及 HM 处理实践，如产妇筛查、巴氏消毒、储存和劳动力。
在 255 个 NICU 中，有 174 个（67.8%）对调查做出了回应。37 个单位（22.2%）进行了母体 CMV 筛查，44 个单位（26.5%）进行了 HM 中的 CMV 失活。对于 CMV 失活，约 90%的单位采用冻融法。在 70%提供 CMV 失活的单位中，无论婴儿的体重和校正胎龄如何，都会在婴儿出院前进行 CMV 失活。在调查期间，43 个单位（25.7%）观察到早产儿获得性 CMV 感染。
日本 NICU 采用了广泛的 HM 处理方法。应制定 NICU 中 HM 处理的国家指南，以促进 CMV 的感染控制。
