Katherine Blackshaw1, Peter Valtchev1, Nooshin Koolaji1, Nina Berry2, Aaron Schindeler1,3, Fariba Dehghani1, Richard B Banati4,5,6. 1. School of Chemical and Biomolecular Sciences, Faculty of Engineering, University of Sydney, Camperdown, NSW2006, Australia. 2. School of Public Health, University of Sydney, Camperdown, NSW2006, Australia. 3. Bioengineering and Molecular Medicine Laboratory, The Children's Hospital at Westmead, Westmead, NSW2145, Australia. 4. Mother's Milk Bank Charity and Australian Breast Milk Bank Consortium (Human Milk Emergency Reserve Project), Bilinga, QLD4225, Australia. 5. Faculty of Medicine and Health, Brain and Mind Centre, University of Sydney, Camperdown, NSW2006, Australia. 6. Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW2234, Australia.
Abstract
OBJECTIVE: This review collates the published reports that focus on microbial and viral illnesses that can be transmitted by breast milk, donor milk and powdered infant formula (PIF). In this context, we attempt to define a risk framework encompassing those hazards, exposure scenarios, vulnerability and protective factors. DESIGN: A literature search was performed for reported cases of morbidity and mortality associated with different infant feeding modes. SETTING: Exclusive breast-feeding is the recommended for infant feeding under 6 months, or failing that, provision of donated human milk. However, the use of PIF remains high despite its intrinsic and extrinsic risk of microbial contamination, as well as the potential for adverse physiological effects, including infant gut dysbiosis. RESULTS: Viable pathogen transmission via breast-feeding or donor milk (pasteurised and unpasteurised) is rare. However, transmission of HIV and human T-cell lymphotropic virus-1 is a concern for breast-feeding mothers, particularly for mothers undertaking a mixed feeding mode (PIF and breast-feeding). In PIF, intrinsic and extrinsic microbial contamination, such as Cronobacter and Salmonella, remain significant identifiable causes of infant morbidity and mortality. CONCLUSIONS: Disease transmission through breast-feeding or donor human milk is rare, most likely owing to its complex intrinsically protective composition of human milk and protection of the infant gut lining. Contamination of PIF and the morbidity associated with this is likely underappreciated in terms of community risk. A better system of safe donor milk sharing that also establishes security of supply for non-hospitalised healthy infants in need of breast milk would reduce the reliance on PIF.
OBJECTIVE: This review collates the published reports that focus on microbial and viral illnesses that can be transmitted by breast milk, donor milk and powdered infant formula (PIF). In this context, we attempt to define a risk framework encompassing those hazards, exposure scenarios, vulnerability and protective factors. DESIGN: A literature search was performed for reported cases of morbidity and mortality associated with different infant feeding modes. SETTING: Exclusive breast-feeding is the recommended for infant feeding under 6 months, or failing that, provision of donated human milk. However, the use of PIF remains high despite its intrinsic and extrinsic risk of microbial contamination, as well as the potential for adverse physiological effects, including infant gut dysbiosis. RESULTS: Viable pathogen transmission via breast-feeding or donor milk (pasteurised and unpasteurised) is rare. However, transmission of HIV and human T-cell lymphotropic virus-1 is a concern for breast-feeding mothers, particularly for mothers undertaking a mixed feeding mode (PIF and breast-feeding). In PIF, intrinsic and extrinsic microbial contamination, such as Cronobacter and Salmonella, remain significant identifiable causes of infant morbidity and mortality. CONCLUSIONS: Disease transmission through breast-feeding or donor human milk is rare, most likely owing to its complex intrinsically protective composition of human milk and protection of the infant gut lining. Contamination of PIF and the morbidity associated with this is likely underappreciated in terms of community risk. A better system of safe donor milk sharing that also establishes security of supply for non-hospitalised healthy infants in need of breast milk would reduce the reliance on PIF.
Entities:
Keywords:
Breastfeeding; Contamination; Human milk; Infant formula; Infection risk; Pathogen
Authors: Jéssica Bomfim de Almeida; Suzi Pacheco de Carvalho; Lucas S C da Silva; Yasmin M F S Andrade; Raiane Cardoso Chamon; Kátia Regina Netto Dos Santos; Lucas M Marques Journal: Braz J Microbiol Date: 2020-08-21 Impact factor: 2.476