The risk of infectious pathogens in breast-feeding, donated human milk and breast milk substitutes

Bibliographic Data

ID15091807
AuthorsKatherine Blackshaw (The University of Sydney), Peter Valtchev (0000-0002-2622-5721, The University of Sydney), Nooshin Koolaji (The University of Sydney), Nina Berry, Nina J Berry (The University of Sydney), Aaron Schindeler (0000-0002-7757-6281, The University of Sydney), Fariba Dehghani (0000-0002-7805-8101, The University of Sydney), Richard B Banati (0000-0003-3558-597X, The University of Sydney, corresponding author)
Year2021
Volume24
Issue7
Pages1725-1740
Publication date2021-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980020000555
PMID32539885
OpenAlexW3035651773
LanguageEN
Citations received3
References cited119

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

Biology · Breast feeding · Breast milk · Breastfeeding · Cronobacter · Environmental health · Infant formula · Breastfeeding Practices and Influences · Enterobacteriaceae and Cronobacter Research · Infant Nutrition and Health · Medicine · Pediatrics

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