Diana Escuder-Vieco1, Óscar Garcia-Algar2, Simona Pichini3, Roberta Pacifici3, Nadia Raquel García-Lara4, Carmen Rosa Pallás-Alonso4. 1. Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain; SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain. Electronic address: diana.e.vieco@gmail.com. 2. SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain; URIE, Hospital del Mar, Institut Municipal d`Investigacio Medica (IMIM), Parc de Salut Mar, Barcelona, Spain. 3. Instituto Superiore di Sanità, Rome, Italy. 4. Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain; SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain.
Abstract
OBJECTIVES: To validate the health and lifestyle questionnaire answered by donors to a human milk bank with respect to the presence of illegal drugs, nicotine, and caffeine levels in donor milk. STUDY DESIGN: A total of 400 human milk samples from 63 donors were analyzed by liquid chromatography tandem mass spectrometry for the presence of 14 illegal drugs, nicotine, and caffeine. Demographics and clinical and lifestyle data (illegal drugs, tobacco, and caffeinated beverage use) were collected from the required screening questionnaire of a human milk bank. The relationship between the 2 evaluation techniques was determined. RESULTS: Illegal drugs were not found in donor milk. Nicotine (46.1 ng/mL) and cotinine (138.6 ng/mL) were quantified in one milk sample from a donor who did not report tobacco use in the questionnaire (1.6% false negative). Caffeine was detected in 45.3% (181/400) of the total milk samples, with a mean concentration of 496 ± 778 ng/mL. The sensitivity and specificity of the questionnaire to detect caffeine in donor milk was 46% and 77%, respectively. CONCLUSIONS: The lifestyle questionnaire is reliable for the assessment of illicit drug use by donors to a human milk bank, but there are certain limitations regarding the identification of second-hand smoke exposure and the disclosure of consumption of caffeinated beverages. Data such as smoking habits of partners, type and volume of beverage or food containing caffeine, method of preparation, and time of day of consumption should be collected by the questionnaire.
OBJECTIVES: To validate the health and lifestyle questionnaire answered by donors to a human milk bank with respect to the presence of illegal drugs, nicotine, and caffeine levels in donor milk. STUDY DESIGN: A total of 400 human milk samples from 63 donors were analyzed by liquid chromatography tandem mass spectrometry for the presence of 14 illegal drugs, nicotine, and caffeine. Demographics and clinical and lifestyle data (illegal drugs, tobacco, and caffeinated beverage use) were collected from the required screening questionnaire of a human milk bank. The relationship between the 2 evaluation techniques was determined. RESULTS: Illegal drugs were not found in donor milk. Nicotine (46.1 ng/mL) and cotinine (138.6 ng/mL) were quantified in one milk sample from a donor who did not report tobacco use in the questionnaire (1.6% false negative). Caffeine was detected in 45.3% (181/400) of the total milk samples, with a mean concentration of 496 ± 778 ng/mL. The sensitivity and specificity of the questionnaire to detect caffeine in donor milk was 46% and 77%, respectively. CONCLUSIONS: The lifestyle questionnaire is reliable for the assessment of illicit drug use by donors to a human milk bank, but there are certain limitations regarding the identification of second-hand smoke exposure and the disclosure of consumption of caffeinated beverages. Data such as smoking habits of partners, type and volume of beverage or food containing caffeine, method of preparation, and time of day of consumption should be collected by the questionnaire.
Authors: Sheela R Geraghty; Kelly McNamara; Jesse J Kwiek; Lynette Rogers; Mark A Klebanoff; Molly Augustine; Sarah A Keim Journal: Breastfeed Med Date: 2015-09-22 Impact factor: 1.817