title: Vitamin content of breast milk from HIV-1-infected mothers before and after flash-heat treatment.
abstract: BACKGROUND
  World Health Organization advocates heat treatment of expressed breastmilk (EBM) as one method to reduce postnatal transmission of human immunodeficiency virus (HIV) in developing countries. Flash-heat is a simple heat treatment method shown to inactivate cell-free HIV.
  
  
  OBJECTIVE
  To determine the effect of flash-heat on vitamin content of milk.
  
  
  METHODS
  Fresh EBM was collected from 50 HIV+ mothers in Durban, South Africa. Mothers washed their hands and then manually expressed 75-150 mL EBM into sterile jars. Milk was aliquoted to unheated controls or flash-heat (50 mL EBM in a glass jar heated in a 450-mL water jacket in an aluminum pan until water boiled, then EBM removed) simulating field conditions with an open flame. Samples were stored at -70 degrees C and then analyzed for the effect of flash-heat on vitamins [A, ascorbic acid, riboflavin (B2), pyridoxal-5-phosphate (B6), folate, and B12].
  
  
  RESULTS
  Vitamin A was not significantly affected by flash-heat and vitamins B12 and C and folate increased significantly. Vitamins B2 and B6 were decreased to 59% (95% confidence interval 44 to 81) and 96% (95% confidence interval 92 to 99), respectively, of that found in unheated milk.
  
  
  CONCLUSIONS
  The percentage remaining after flash-heat suggests that most vitamin concentrations are retained after heating. Flash-heat may be a practical and nutritious infant feeding method for mothers in developing countries.
authors.affiliation: Department of Pediatrics, University of California, Davis Medical Center, 2516 Stockton Boulevard, Room 334, Sacramento, CA 95817, USA. ballardk@berkeley.edu
authors.forename: Kiersten A
authors.initials: KA
authors.lastname: Israel-Ballard
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Abrams
authors.forename: Anna
authors.initials: A
authors.lastname: Coutsoudis
authors.forename: Lindiwe N
authors.initials: LN
authors.lastname: Sibeko
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Cheryk
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Chantry
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1; D006358:Hot Temperature; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008895:Milk, Human / Q000378:metabolism*; D009753:Nutritive Value; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D013242:Sterilization; D014815:Vitamins / Q000032:analysis / Q000378:metabolism*
chemical_list: D014815:Vitamins