title: Validation of a screening questionnaire for a human milk bank to determine the presence of illegal drugs, nicotine, and caffeine.
abstract: OBJECTIVE
  To validate the health and lifestyle questionnaire answered by donors to a human milk bank with respect to the presence of illegal drugs, nicotine, and caffeine levels in donor milk.
  
  
  METHODS
  A total of 400 human milk samples from 63 donors were analyzed by liquid chromatography tandem mass spectrometry for the presence of 14 illegal drugs, nicotine, and caffeine. Demographics and clinical and lifestyle data (illegal drugs, tobacco, and caffeinated beverage use) were collected from the required screening questionnaire of a human milk bank. The relationship between the 2 evaluation techniques was determined.
  
  
  RESULTS
  Illegal drugs were not found in donor milk. Nicotine (46.1 ng/mL) and cotinine (138.6 ng/mL) were quantified in one milk sample from a donor who did not report tobacco use in the questionnaire (1.6% false negative). Caffeine was detected in 45.3% (181/400) of the total milk samples, with a mean concentration of 496 ± 778 ng/mL. The sensitivity and specificity of the questionnaire to detect caffeine in donor milk was 46% and 77%, respectively.
  
  
  CONCLUSIONS
  The lifestyle questionnaire is reliable for the assessment of illicit drug use by donors to a human milk bank, but there are certain limitations regarding the identification of second-hand smoke exposure and the disclosure of consumption of caffeinated beverages. Data such as smoking habits of partners, type and volume of beverage or food containing caffeine, method of preparation, and time of day of consumption should be collected by the questionnaire.
authors.affiliation: Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain; SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain. Electronic address: diana.e.vieco@gmail.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Escuder-Vieco
authors.affiliation: SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain; URIE, Hospital del Mar, Institut Municipal d`Investigacio Medica (IMIM), Parc de Salut Mar, Barcelona, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Garcia-Algar
authors.affiliation: Instituto Superiore di Sanità, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.affiliation: Instituto Superiore di Sanità, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
authors.affiliation: Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain; SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain.
authors.forename: Nadia Raquel
authors.initials: NR
authors.lastname: García-Lara
authors.affiliation: Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain; SAMID Network (Spanish Collaborative Maternal and Child Health Research Network), Barcelona, Spain.
authors.forename: Carmen Rosa
authors.initials: CR
authors.lastname: Pallás-Alonso
mesh_terms: D000328:Adult; D002110:Caffeine / Q000032:analysis*; D046148:Donor Selection / Q000379:methods*; D006304:Health Status; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis*; D008019:Life Style; D008875:Middle Aged; D017784:Milk Banks; D008895:Milk, Human / Q000737:chemistry*; D009538:Nicotine / Q000032:analysis*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D002110:Caffeine; D009538:Nicotine