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Infant formula safety and the safety and efficacy of donor human milk文档
Guidelines for donor milk banking in the US As members, all voluntarily follow the Guidelines for the Establishment and Operation of a Donor Human Milk Bank, generated by HMBANA. Guidelines include protocols for soliciting donors and collecting, processing and distributing milk. All donors screened for antibodies to HIV-1, HIV-2, HTLV-1, HTLV-2, HBs Ag, Hep C, and syphilis. Donors must also provide a full health and risk history and PPD if appropriate. Tully, J Hum Lact, 2002;18:393-6. Donor milk is dispensed either on hospital purchase order or physician order for a baby not hospitalized. Donor milk banks are non-profit. All milk is donated. Cost associated with donor screening and milk processing is offset by a processing fee (~$3.50/oz in the US for HMBANA milk) which is usually paid by the ordering institution or the recipient. Some insurance policies cover this. Donor milk supply and costs Donor qualifications Milk donations obtained from healthy donors (not paid) after medical history. Donor is screened for markers to HBV, HCV, HIV-1 and 2, HLTV-1 and 2, and syphilis. The milk is matched with the donor using DNA “fingerprinting.” Each lot of milk is screened for the presence of bacterial contamination, drugs, and non-human proteins. A sample analyzed for calories and macronutrients. Milk is either centrifuged to separate the fat or ultra-filtrated to concentrate proteins. The skim and cream are blended to bring the milk macronutrients to target levels. Commercial donor milk bank Milk is pasteurized using a High Temp Short Time (HTST) process (standard temp: 57°C-72°C). After pasteurization, milk is stored at -30°C. Pathogen log-reduction of HIV is 7.3 Similar results for other bacteria and viruses Methods similar to those used in preparation of human blood products. Commercial milk banking procedures Donor milk banking: Efficacy? Effect of Commercial Pasteurization Conditions on Human Milk Constituents Parameter Untreated Milk Pasteurized % Remaining
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