Refining processes to maximize the provision of donor human milk rich in nutrients and bioactive components: An integrated multidisciplinary approach at a human milk bank serving critically-ill neona

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Infant formulas attempt to mimic the nutrient composition of human breastmilk, but cannot provide its bioactive factors. These factors enhance immune function, and optimum growth and development of the newborn. Human milk is also the best health promoter for preterm babies (approximately 10 % of the 350,000 children born annually in Canada), who are often ill and may require extended hospitalization. However, preterm babies may be separated from their mothers while hospitalized, or mothers may not be able to produce an adequate milk supply due to their own illness and/or stress associated with preterm delivery. The Rogers Hixon Ontario Human Milk Bank (OMB) dispenses, by prescription, milk from approved donor mothers to these ill newborns. At the OMB, donated milk undergoes thermal pasteurization (heating at 62.5°C for 30 min). This heat treatment has two fundamental problems: 1) nutrient composition is affected and human milk bioactive molecules may be inactivated, and 2) Bacillus cereus, a spore-forming bacterium, can resist pasteurization. Because current methods cannot differentiate between pathogenic and non-pathogenic B. cereus, the OMB must discard 15-30% of their milk supply. We have formed a multidisciplinary team that will tackle these two problems simultaneously. Firstly, by adopting a non-thermal pasteurization method known as high hydrostatic pressure pasteurization (HHPP), we hypothesize that we will be able to preserve milk nutrients and biologically active molecules. Consequently, the OMB will be able to dispense donor milk that can fully exert its multiple beneficial biological/immunological functions, improving health outcomes for vulnerable infants. Secondly, we will leverage HHPP to further reduce B. cereus contamination, and create and deploy genome-based bioinformatics means to differentiate between non-pathogenic and pathogenic B. cereus. As a result, our research will help reduce milk losses, and permit the OMB to serve more preterm newborns.