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Pasteurization

NEW Milk Analysis Process at The Milk Bank

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The Milk Bank continually seeks to provide the highest quality of safe Pasteurized Donor Human Milk (PDHM) to infants in most need. We know that the variability of nutritional content of donor milk can be a concern for the adequate growth of fragile infants. We are pleased to be able to provide nutritional analysis of PDHM for each target pool of donor milk. We intentionally mix donors’ milk in volume-specific ways to obtain a minimum of 20 calories per ounce for hospital clients.

Each bottle of milk now contains a label that lists overall caloric content and protein content. To determine and verify these values, milk is tested from each pool of donor milk. Our equipment reads fat, lactose, and protein content of the milk, allowing for specific pooling of milk to ensure adequate calories and protein content. Knowledge of the nutritional content of milk will:

  1. allow for targeting milk for specific babies and
  2. determine specific fortification processes.

While this does not replace the process of monitoring babies’ individual growth, it is an extra tool to ensure optimum nutrients for fragile infants in hospital care. We’re happy to share there will be no increase in the purchase cost for all of our PDHM.

Do you have questions about our new process we can help answer? Email us at engagement@themilkbank.org!

More on Pasteurization Equipment

By Jami Marvin, January 2018

Have you ever wondered what really goes into pasteurizing milk? There is so much more to it than anyone ever thinks! We've previously talked about the larger equipment that is required to process milk such as the pasteurizer itself, but there are smaller and equally important pieces as well.

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Some of the smallest but most important things we use are data loggers. They are about the size of a hockey puck but their use is of utmost importance. These little things track and log the temperature of the milk every minute during the pasteurization cycle to ensure the milk is properly processed. Without these, we would not be able to show the milk actually went through the pasteurization process. Each batch of milk that is done has an individual graph with the date, time, and temperatures during the cycle.

Another important piece of equipment is something simple - Thermometers! We use both digital and analog thermometers. There is one of each in each of our freezers. The digital thermometers connect to a cloud and log daily temperatures, the analog thermometers back up the digital. Our walk-in freezer is equipped with thermometers that not only email us daily with a log, they also email us to inform us if the power has gone out in case of emergency. This is extremely important during the stormy season!

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Labels are another extremely important item we must have. Every deposit, batch and bottle must have a label for us to easily identify who the milk belongs to, where it needs to go, when it expires and what the next step might be for it. The labels allow us to stay extremely organized, which is vital to ensuring we are providing safe pasteurized donor human milk.
 

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The last items to think about are the bottles we use. A bottle is a bottle, right? Wrong!  Our bottles come to us pre-sterilized so that we know the milk is going into a safe container. They include foil seals inside the lids, which are adhered using an induction sealer immediately after being filled. The bottles are specific to the pasteurizer we use. They require cages to hold them in place and to keep them submerged in the water. The bottles must be able to withstand the temperatures of the pasteurization process and the freezer as well. Who would have thought so much was required of a simple bottle?

Providing safe pasteurized donor human milk is our number one priority. All of the safety measures we take are to ensure the fragile babies and premature infants are receiving the best option available, aside from their mothers’ own milk. We are always looking for ways to rise above the standards, whether that be implementing new processes or equipment. It’s all important to the end goal. Why do we do it? The answer is simple. We care.

If you’d like to read up on some of our bigger equipment, check out this blog!
https://www.themilkbank.org/blog-2/2017/7/17/the-milk-bank-has-new-pasteurization-equipment

Why Do We Pasteurize Breast Milk Donations?

We are often asked, “Why do you pasteurize your milk donations?” The simple answer is this: because pasteurization kills the bad while retaining the good. But that answer doesn’t always satisfy those that think breastmilk is best raw form. While generally, we agree: breastmilk is best untouched, our mission is to provide donor milk to the population of infants who are most susceptible to infection. It’s our job to provide the best nutrition while ensuring we do no harm. Both the American College of Pediatricians and the Center for Disease Control recommend pasteurized human donor milk if mother’s own milk is unavailable and that means we have a responsibility to ensure proper procedures.

Before we pasteurize milk donations, we first make sure that our donors are free of communicable diseases and are generally healthy with limited medication use. We require a blood test for all our milk donors to check for HIV, HTLV, Syphilis, Hepatitis B &C. We make sure our donors maintain lifestyles that are compatible for donation- they are a non-smoker, aren’t taking a medication that will affect a premature baby and pump and store their milk in a safe way.

 

But what about the milk itself? What in the milk is killed during pasteurization and what is maintained?

 

First, let’s talk about what is retained.

  • The enzyme that destroys bacteria by disrupting their cell walls retains 75 percent of its activity. Lysozyme, with many other bioactive components, allow a baby to create their own immunity in their urinary tract. Meaning, babies fed breast milk are less likely to develop a urinary tract infection.
  • Oligosaccharides, a complex chain of sugars unique to human milk are unchanged by pasteurization. You might be wondering, why are these sugars important? They exist to feed the tiny organisms that make up a baby's digestive system. In fact, some researchers believe that human milk was evolved to be more protective than to provide nutrition.
  • 70 percent of the concentrated IgA antibodies are also retained through pasteurization. These are the antibodies to things like E. coli, group B streptococci and Brucella abortus, all bacteria that can be harmful, if not deadly to a preterm infant.

 

So, how does breastmilk change when pasteurized?

  • The good news is, not much changes! Well, aside from the things we want to change like the elimination of pathogens and viruses.
  • Some of you might have heard about lipase or have experienced high amounts of it in your own frozen milk, pasteurization inactivates the enzyme.

 

Our final step to ensure sure the milk we are sending to the most fragile infants is completely safe involves testing for potential bacteria. Each batch has a random sample checked by an independent lab that performs a 48- hour culture to check that all potential pathogens and viruses are destroyed.

 

If you have a question you would like answered, email us  at info@themilkbank.org or connect with us on Facebook and Twitter.

 

 

A Day in the Pasteurization Room

By Jami Marvin, Pasteurization Technician, Indiana Mothers' Milk Bank

First thing in the morning we come in and clean. Cleaning plays a vital role in keeping the milk safe for babies. After everything is cleaned, it is then time to see what is going on with the milk for that particular day. Most days, there is already thawed milk in the refrigerator that is waiting to be processed. But, let’s start from the beginning.

When the milk first arrives in our building, it is sorted into bins. We sort it by the mom’s names, and then into the months that it was pumped. That milk then gets put into our Raw Milk Freezer until it’s time to be thawed. Once all the milk has been entered into the intake log, it is then the job of the Pasteurization Coordinator to decide which milk will be put together into which batch. A batch is roughly 650-700 ounces of frozen breast milk that has generally been pumped within a three month time frame. It is preferred that the milk comes from 2-5 different moms, so that we can ensure there is a good average of calories per bottle.

Copyright Indiana Mothers' Milk Bank
Copyright Indiana Mothers' Milk Bank

Once the milk has been designated to a batch, it is time to pull the milk from the freezer to begin the thawing process. We pull the assigned bags in each batch and arrange the milk into wire racks so that it can thaw evenly.

After the milk has had time to thaw, but while it is still partially frozen, we begin the flasking part of the process. Before we begin, we sanitize all counter tops and hands and put on a clean pair of gloves. We also wear aprons, hair nets and masks. Masks are always worn when there is open milk in the pasteurization room.  We take each bag or bottle out of the rack and wipe down any condensation. It is during this process that we inspect the bag or bottle to make sure it is not leaking and to see if it is still properly sealed. The most common thing we find are holes in bags that cause the milk to leak out. If there is a leak in a bag, we have to throw it out because if milk is coming out, then germs can potentially get in. The end result is what we call a ‘breast milk slushy.’ That ‘breast milk slushy’ goes into the refrigerator until it is ready for the next step.

The milk typically sits in the refrigerator overnight so that the remaining ice can melt and the milk is all liquid the next day. The next step is the pooling, or homogenizing step of the process. To pool the milk, we put the flasks of thawed milk into a table that sits in the middle of the room.  We even out each flask so that there is about 1400 milliliters of milk in each. Then the first flask is picked up, swirled gently, and then half of what is in the flask is poured into the next flask. Each flask must be swirled and poured into the next flask until we have gone around the table ten times.

Homogenizing
Homogenizing

The next step is bottling. Full term milk is bottled in 4 ounce portions, and Pre-Term milk is bottled into 2 ounce portions. Pre-Term is milk from a mom that had a baby before 36 weeks of gestation. Pre-Term milk has more nutrients, so it is put into smaller portions so that the smallest babies will get just what they need. The bottles are then sealed with an induction sealer. Then we check each bottle to ensure that it properly sealed.

Once every bottle has been checked, the batch gets to go into the pasteurizer for a hot bath. It heats the milk to the designated temperature for the allotted amount of time, and then it is rapidly cooled. When the machine is done with the cycle, it is our job to properly label each bottle and then place them in the freezer. One bottle from each batch is sent to the lab for testing and when the final lab reports come in, we know that it is ok to send out the milk or discard anything if necessary.

So, there you have it! This is what we do in a day, and now you know how we handle liquid gold.

Milk Bank Misconceptions

What was your first thought when you learned there was a local Milk Bank?  Most often the reaction we receive is disbelief that such a resource has been around for 6 years in Indiana and much longer in other states. Sometimes, people ask if we help pump moms milk in our office. That makes us laugh.

So, today we are going to dispel some misconceptions.

  • Anyone can just drop off milk: No, Sorry. We have to ensure the safety of our milk and therefore our Milk Donors are required to go through an approval process that involves in depth medical questioning, blood testing and the approval of both Mom’s Healthcare Provider and the baby’s Pediatrician,
  • Donors have to pay to donate: Not the case, in fact we cover all the cost of donating including the cost of drawing and testing your blood. We pay for shipping, we can provide milk storage bags, and if  you’re local we’ll pick up your milk.
  • The approval process is too intimidating:  We hope not. From the packet we only need a few forms back. The Healthcare Provider forms will need to be signed by your doctors but we will fax them if you cannot get them signed. After we receive all the forms, the last step is to have your blood drawn. Donors can go to any Quest Diagnostic location and if the Quest location is not convenient, we will ship you a blood draw kit that you can take to a lab or doctors office or nurse to have your blood drawn.   Quick tip: If you ask, most healthcare providers will donate their time to draw your blood if you explain what it’s for.
  • My milk has been in the freezer for 6 months, can you take it? YES! If you are an approved donor, we can take milk that has been stored for 6-7 months. That means milk that was pumped 6 months ago.  If you have a specific question, PLEASE CALL US! We do not want to see your milk go to waste.
  • Why can we only accept milk that has been stored for 6 months?  Breast milk that has been frozen for longer then 6 months starts to loose some of it’s nutritional value.
  • IMMB can only accept milk that was pumped in my first 6 months post partum:  NO! Not true! IMMB can accept milk that has been pumped throughout your child’s first year of life and has been stored in your freezer for no longer then 6 months.
  • I donated 6 months ago when my baby was 3 months old, do I need to be re-approved? Absolutely not! Your initial approval is valid until your baby is a year old and milk you pump can still be accepted after their first birthday if it was pumped before they turned one. Confused yet?
  • IMMB can only accept milk pumped in the bags we provide: Nope. We can send you bags if you need them but we can accept milk in any brand of milk storage bag. Ziplock bags excluded. We prefer bags to milk frozen in storage trays.
  • I don’t have 100 ounces to give right now can I still donate?  YES! We just ask that you provide us with 100oz before your baby’s first birthday,
  • I can’t donate, I’m taking prescription medication. Not so! There are some medications that are perfectly compatible with donating like synthroid or the mini pill. Prenatal vitamins are also fine if they do not contain herbs. We'd love to talk to you about your specific medication before determining if you're medication is compatible with donating. Email us, call us or find us on Facebook or Twitter!
  • Human Milk Banking is too new.  Not true! We’ve been around since 2005 but other Milk Banks associated with the Human Milk Banking Association of North America have been around since the 70’s.
  • IMMB pays Donors for their human milk donation. Nope. Not true. We are a non-profit and rely upon the generosity of our Donors to be able to provide Pasteurized Donor Human Milk to premature and sick NICU babies. We are a community milk bank and look for community grants to help support our Mission also.
  • People only donate for compensation. We have been so blessed to have received the excess breast milk from Doctors, Lawyers, Teachers, and Stay at Home Moms who have maintained a pumping schedule when they returned to work and have found they have more then their own child will consume.  Our donors are willing to donate their milk without compensation because they know how important breast milk can be to sick or fragile babies.
  • Pasteurized Donor Human Milk is free.  Unfortunately, PDHM is not free. We wish we could provide the life saving properties of human milk to all babies for free but we can’t. So we charge a processing fee to our ordering hospitals to cover the costs of the milk bank.
  • Why is PDHM so expensive? We wish it wasn’t but unfortunately we process the milk by hand. We thaw it, combine it and bottle it by hand. The only automated part of our process is the actual pasteurization that is done in a machine that brings the milk up to the appropriate temperature for the appropriate amount of time.
  • Why can’t Donors ship milk on Thursdays? Simply because Thursday is too close to the weekend. If the shipping carrier would mess up and not deliver your milk on Friday, we wouldn’t get the box till Monday and there is nothing worse than breast milk sitting unrefrigerated for 3+ days. So, to be on the safe side we ask that Donors only ship to us Monday thru Wednesday.
  • Why isn’t there a Milk Depot near me? We’d like more depots! We’d like to make donating to us the easiest experience possible and Milk Depots help to alleviate the hassle of packing a box, finding dry ice and taking the box to UPS. If you know of a business or organization who would be willing to volunteer their time to be a Milk Depot, let us know!
  • Someone in my home has a cold, can I donate milk pumped durning that time? We ask that you notify us if someone in your household has more then a cold so that we can determine the level of risk to the milk. Most times that is no reason why we cannot accept milk pumped during these times. Our biggest concern is medication. If you become sick and take a medication or herbal treatment, please let us know.
  • I called you today, why didn’t you return my phone call today? Please forgive us if this is the case but please know that we are a staffed with 3 full time employees who wear many hats. Trust us,  we’re just really busy. Please have patience with us. Always feel free to email your need or request, we can answer emails long after we’ve left the office. We're available on Facebook and Twitter too!