High-Pressure Processing of Human Milk: A Balance between Microbial Inactivation and Bioactive Protein Preservation

J Nutr. 2023 Sep;153(9):2598-2611. doi: 10.1016/j.tjnut.2023.07.001. Epub 2023 Jul 8.

Abstract

Background: Donor human milk banks use Holder pasteurization (HoP; 62.5°C, 30 min) to reduce pathogens in donor human milk, but this process damages some bioactive milk proteins.

Objectives: We aimed to determine minimal parameters for high-pressure processing (HPP) to achieve >5-log reductions of relevant bacteria in human milk and how these parameters affect an array of bioactive proteins.

Methods: Pooled raw human milk inoculated with relevant pathogens (Enterococcus faecium, Staphylococcus aureus, Listeria monocytogenes, Cronobacter sakazakii) or microbial quality indicators (Bacillus subtilis and Paenibacillus spp. spores) at 7 log CFU/mL was processed at 300-500 MPa at 16-19°C (due to adiabatic heating) for 1-9 min. Surviving microbes were enumerated using standard plate counting methods. For raw milk, and HPP-treated and HoP-treated milk, the immunoreactivity of an array of bioactive proteins was assessed via ELISA and the activity of bile salt-stimulated lipase (BSSL) was determined via a colorimetric substrate assay.

Results: Treatment at 500 MPa for 9 min resulted in >5-log reductions of all vegetative bacteria, but <1-log reduction in B. subtilis and Paenibacillus spores. HoP decreased immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G, lactoferrin, elastase and polymeric immunoglobulin receptor (PIGR) concentrations, and BSSL activity. The treatment at 500 MPa for 9 min preserved more IgA, IgM, elastase, lactoferrin, PIGR, and BSSL than HoP. HoP and HPP treatments up to 500 MPa for 9 min caused no losses in osteopontin, lysozyme, α-lactalbumin and vascular endothelial growth factor.

Conclusion: Compared with HoP, HPP at 500 MPa for 9 min provides >5-log reduction of tested vegetative neonatal pathogens with improved retention of IgA, IgM, lactoferrin, elastase, PIGR, and BSSL in human milk.

Keywords: antibody; breast milk; enzyme; infant nutrition; microbial inactivation; mother’s milk; premature infant; preterm infant; protease; thermal processing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Immunoglobulin A
  • Immunoglobulin M
  • Infant, Newborn
  • Lactoferrin*
  • Microbial Viability
  • Milk, Human* / microbiology
  • Pancreatic Elastase
  • Pasteurization / methods
  • Vascular Endothelial Growth Factor A

Substances

  • Lactoferrin
  • Vascular Endothelial Growth Factor A
  • Immunoglobulin A
  • Immunoglobulin M
  • Pancreatic Elastase