As more and more hospitals start using Co-Op Donor Milk, I’m continuously surprised by the myths surrounding donor milk. Here are the first two:
1. “All donor breast milk is sterile.”
UNTRUE. Pasteurization does not result in a sterile product. It does lower the bioburden substantially, leaving a small percentage of bacteria untouched. Of more concern is that the pasteurization method used by virtually all milk banks (Holder pasteurization) does not eradicate spores, including the potentially lethal spores of bacillis cereus. B. cereus is difficult to detect as reported by Landers and Updegrove, “Bacteriological Screen of Donor Human Milk before and After Holder Pasteurization” (Breastfeeding Medicine, 2012 June;5(3):117-21.
Only Co-Op Donor Milk from Medolac Laboratories is commercially sterile.
2. “There is no need to screen raw donor milk for potential pathogens as it is just as good to test the milk after it’s processed to be sure everything has been killed.”
UNTRUE. Medolac Laboratories rejects about 12% of raw donor milk for unacceptably high levels of bacteria, yeast and mold. Certain bacteria, like s. aureus, b. cereus and e.coli, produce toxins when present in high levels. Not knowing the level of bacteria in raw milk means that heat stable toxins may remain in the milk, even if the thermal process succeeds in killing the pathogen. Because donor milk is used on the smallest and most fragile babies in the neonatal unit, it makes no sense to bypass bacterial screening and take the chance of providing donor milk with potentially lethal heat stable toxins.
Donor milk is a lifesaver for many babies but it is not magic. Human milk provides an excellent growth medium for bacteria and can easily become contaminated during pumping, storing and dispensing. Knowing the facts about donor milk will enable hospitals to make informed decisions about their suppliers.