title: Effect of flash-heat treatment on antimicrobial activity of breastmilk.
abstract: OBJECTIVE
  The World Health Organization recommends human immunodeficiency virus (HIV)-positive mothers in resource-poor regions heat-treat expressed breastmilk during periods of increased maternal-to-child transmission risk. Flash-heat, a "low tech" pasteurization method, inactivates HIV, but effects on milk protein bioactivity are unknown. The objectives were to measure flash-heat's effect on antimicrobial properties of lactoferrin, lysozyme, and whole milk and on the digestive resistance of lactoferrin and lysozyme.
  
  
  METHODS
  Flash-heated and unheated breastmilk aliquots from HIV-positive mothers in South Africa were "spiked" with Staphylococcus aureus and Escherichia coli and then cultured for 0, 3, and 6 hours. Lysozyme and lactoferrin activities were determined by lysis of Micrococcus luteus cells and inhibition of enteropathogenic E. coli, respectively, measured spectrophotometrically. Percentages of proteins surviving in vitro digestion, lactoferrin and lysozyme activity, and bacteriostatic activity of whole milk in heated versus unheated samples were compared.
  
  
  RESULTS
  There was no difference in rate of growth of E. coli or S. aureus in flash-heated versus unheated whole milk (p = 0.61 and p = 0.96, respectively). Mean (95% confidence interval) antibacterial activity of lactoferrin was diminished 11.1% (7.8%, 14.3%) and that of lysozyme by up to 56.6% (47.1%, 64.5%) by flash-heat. Digestion of lysozyme was unaffected (p = 0.12), but 25.4% less lactoferrin survived digestion (p < 0.0001).
  
  
  CONCLUSIONS
  In summary, flash-heat resulted in minimally decreased lactoferrin and moderately decreased lysozyme bioactivity, but bacteriostatic activity of whole milk against representative bacteria was unaffected. This suggests flash-heated breastmilk likely has a similar profile of resistance to bacterial contamination as that of unheated milk. Clinical significance of the decreased bioactivity should be tested in clinical trials.
authors.affiliation: Department of Pediatrics, University of California Davis Medical Center, Sacramento, California 95817, USA. caroline.chantry@ucdmc.ucdavis.edu
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Chantry
authors.forename: Jean
authors.initials: J
authors.lastname: Wiedeman
authors.forename: Gertrude
authors.initials: G
authors.lastname: Buehring
authors.forename: Janet M
authors.initials: JM
authors.lastname: Peerson
authors.forename: Kweku
authors.initials: K
authors.lastname: Hayfron
authors.forename: Okumu
authors.initials: O
authors.lastname: K'Aluoch
authors.forename: Bo
authors.initials: B
authors.lastname: Lonnerdal
authors.forename: Kiersten
authors.initials: K
authors.lastname: Israel-Ballard
authors.forename: Anna
authors.initials: A
authors.lastname: Coutsoudis
authors.forename: Barbara
authors.initials: B
authors.lastname: Abrams
mesh_terms: D000890:Anti-Infective Agents / Q000378:metabolism / Q000528:radiation effects; D001942:Breast Feeding; D003906:Developing Countries; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1 / Q000528:radiation effects; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007781:Lactoferrin / Q000378:metabolism / Q000528:radiation effects*; D008826:Microbial Sensitivity Tests; D008895:Milk, Human / Q000201:enzymology / Q000528:radiation effects / Q000821:virology; D009113:Muramidase / Q000378:metabolism / Q000528:radiation effects*; D012307:Risk Factors; D013242:Sterilization / Q000379:methods
chemical_list: D000890:Anti-Infective Agents; D009113:Muramidase; D007781:Lactoferrin