IMPACT OF PASTEURIZATION ON THE INTEGRITY OF BIOACTIVE COMPONENTS IN DONOR HUMAN MILK: A LITERATURE REVIEW
DOI:
https://doi.org/10.34011/icihcce.v7i2.384Keywords:
donor human milk, Holder pasteurization, bioactive components, high-pressure processingAbstract
Background: Human milk is the gold standard for neonatal nutrition, particularly for preterm and very low birth weight (VLBW) infants. When mother’s own milk is unavailable or insufficient, donor human milk provided through human milk banks is the preferred alternative. To ensure microbiological safety, donor human milk undergoes pasteurization; however, thermal processing may compromise bioactive components essential for immune protection and gastrointestinal development.
Objective: This review aimed to evaluate current evidence regarding the effects of pasteurization on the preservation of bioactive components in donor human milk and to assess emerging processing technologies and their clinical implications.
Methods: A structured narrative review was conducted using evidence from randomized controlled trials (RCTs), systematic reviews, scoping reviews, and international clinical guidelines published primarily between 2015 and 2026. Literature was identified through PubMed/MEDLINE, Scopus, Cochrane Library, and ScienceDirect.
Results: Holder Pasteurization (HoP) (62.5°C for 30 minutes) effectively inactivates microbial pathogens but reduces several key immunological components, including secretory immunoglobulin A (17.6–50%), lactoferrin (5.6–80%), and lysozyme (9.8–35%), while nearly eliminating bile salt–stimulated lipase activity. In contrast, human milk oligosaccharides (HMOs), most minerals, and water-soluble vitamins remain relatively stable. Alternative technologies, including High-Pressure Processing (HPP) and High-Temperature Short-Time (HTST) pasteurization, demonstrated improved preservation of bioactive activity.
Conclusion: Despite reducing selected bioactive components, pasteurized donor human milk remains clinically superior to infant formula and contributes to lowering the risk of necrotizing enterocolitis (NEC). Further development of advanced processing technologies and optimized thermal control is needed to maximize bioactive preservation.
Keywords: donor human milk; Holder pasteurization; bioactive components; high-pressure processing
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