title: Cultures of Holder-pasteurized donor human milk after use in a neonatal intensive care unit.
abstract: OBJECTIVE
  Current guidelines state that human milk, once thawed, should be kept in a refrigerator for only 24 hours. We cultured Holder-pasteurized donor human milk (DHM) after thawing and refrigeration under clinical conditions.
  
  
  METHODS
  Bottles of pasteurized DHM were thawed and used in a regional level 3 neonatal intensive care unit (NICU) in standard clinical fashion and kept refrigerated when not in use. Once no longer needed clinically, aliquots were cultured for bacteria.
  
  
  RESULTS
  In total, 30 bottles were returned for culture; six were excluded from analysis because human milk fortifier had been added, and two had been left out of the refrigerator. The remaining 22 bottles were culture-negative after having been thawed for 7-122 hours.
  
  
  CONCLUSIONS
  DHM without additives was culture-negative for 24 hours or longer after thawing and routine NICU handling. These data indicate that unfortified Holder-pasteurized DHM handled appropriately and refrigerated remains sterile for 24 hours after thawing and perhaps longer. Further study is needed to confirm this.
authors.affiliation: Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, California 94304, USA. rscohen@stanford.edu
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Cohen
authors.forename: Chien-Fang Riva
authors.initials: CF
authors.lastname: Huang
authors.forename: Sean C
authors.initials: SC
authors.lastname: Xiong
authors.forename: Pauline
authors.initials: P
authors.lastname: Sakamoto
mesh_terms: D015169:Colony Count, Microbial / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D005615:Freezing; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008895:Milk, Human / Q000276:immunology / Q000382:microbiology*; D061352:Pasteurization; D011247:Pregnancy; D012034:Refrigeration; D013997:Time Factors; D014019:Tissue Donors