Naomi E.F. Dewanto Department of Pediatric, Tarumanagara University. Siloam Hospitals Kebon Jeruk Jakarta e-mail: firstname.lastname@example.org
Breastfeeding and human milk are the best nutrition for all newborn especially preterm and sick babies. The American Academic of Pediatrics recommend that all preterm infants receive mother?s own milk or pasteurized donor milk if mother?s own milk is unavailable.1 However, the composition and bioactivity of MOM and DHM are different. Many essential bioactive components of breast milk are lost with standard pasteurization techniques.2 The process of pasteurization kills the bacteria in milk and thus removes one of the potential bioactive portions, of human milk that may be protective against NEC (it also likely inactivates other bioactive molecules too). Donor milk ? the second best food for premature infants after milk from the infant?s own mother ? is suddenly missing one or more of the factors in human milk that is thought to protect against NEC and other gastrointestinal infections.3 Factors other than pasteurization impact DHM in clinically significant ways, including maturity of mammary gland (preterm MOM vs term DHM), stage of lactation for which DHM replaces MOM (mature DHM replacing MOM colostrum and transitional milk) and freeze-thaw cycles that are inherernt in the storage and processing of DHM.4 It is important to note that simply providing mother?s milk is not the same as breastfeeding, pumping and freezing mother?s own milk and lack of direct mother-infant contact may diminish some of the beneficial effects of breastfeeding. Hospital support of optimal breastfeeding practices is essential with thoughtful integration of donor human milk policies for those infants that need it most. Ensure the use of donor human milk is to replace formula, not to replace mothers? own milk.
1. American Academy of Pediatrics. Breastfeeding and the use of human milk. Pediatrics 2012;129;e827-41 2. J. Neu.Mother?s Own Milk: How Does It Differ from Donor Milk for the Baby. Breastfeeding Med 2019;14:S3-4 3. Cacho NT, Harrison NA, Parker LA, Padgett KA, Lemas DJ, Marcia GE, et al. Personalization of the Microbiota of Donor Human Milk with Mother?s Own Milk.Frontiers in Microbiology 2017;8:1-11 4. Meier P, Patel A, Zweirs AE. Donor Human Milk Update: Evidence, Mechanisms, and Priorities for Research and Practice. J of Ped 2016;13:1-7 5. Brandstetter S, Mansen K, DeMarchis A, Quyhn NN, Engmann C. Ballard KI. A Decision Tree for Donor Human Milk: An Example Tool to Protect, Promote, and Support Breastfeeding.