Safety and reduction of pasteurized donor human milk waste using a 48-h post-thaw usage policy: a retrospective observational and bacteriological study
摘要
Pasteurized donor human milk (PHDM) is recommended for preterm infants when the mother’s own milk is unavailable, as it reduces complications such as necrotizing enterocolitis and supports the early initiation of human milk feeding. Current guidelines in Japan require thawed PDHM to be discarded after 24 h, although emerging evidence suggests that PDHM may remain safe for up to 48 h. This study evaluated the microbiological safety of PDHM at 48 h post-thawing and estimated the amount of waste that could be potentially reduced if the allowable use period were extended.
MethodsForty PHDM samples provided by the Japan Human Milk Bank were thawed and stored at 4 °C. Aliquots were collected at 24 and 48 h post-thawing for quantitative bacterial culture. To estimate potential waste reduction, the medical records of 23 neonates who received PDHM were retrospectively reviewed. For each neonate, the actual PDHM intake, thawed volume, and discarded volume were recorded up to day 15 of life, and the expected reduction in waste under a 48-h use policy was calculated.
ResultsNo bacterial growth was detected in any sample at 24–48 h post-thawing. Among 23 preterm infants who received PDHM, extending the allowable post-thaw usage period to 48h was estimated to save 2,051 mL of PDHM and potentially reduce discarded volume by 84.7%.
ConclusionsUnder routine neonatal intensive care units (NICU) conditions, PDHM remained microbiologically sterile for up to 48 h after thawing. Extending the usage period to 48 h could substantially reduce PDHM waste and help maintain a more stable supply of donor human milk in the NICU. Ensuring a stable PDHM supply may facilitate the early initiation of human milk feeding and support breastfeeding.