title: Demonstrating the efficacy of the FoneAstra pasteurization monitor for human milk pasteurization in resource-limited settings.
abstract: Human milk provides crucial nutrition and immunologic protection for infants. When a mother's own milk is unavailable, donated human milk, pasteurized to destroy bacteria and viruses, is a lifesaving replacement. Flash-heat pasteurization is a simple, low-cost, and commonly used method to make milk safe, but currently there is no system to monitor milk temperature, which challenges quality control. FoneAstra, a smartphone-based mobile pasteurization monitor, removes this barrier by guiding users through pasteurization and documenting consistent and safe practice. This study evaluated FoneAstra's efficacy as a quality control system, particularly in resource-limited settings, by comparing bacterial growth in donor milk flash-heated with and without the device at a neonatal intensive care unit in Durban, South Africa.
  
  
  METHODS
  For 100 samples of donor milk, one aliquot each of prepasteurized milk, milk flash-heated without FoneAstra, and milk pasteurized with FoneAstra was cultured on routine agar for bacterial growth. Isolated bacteria were identified and enumerated.
  
  
  RESULTS
  In total, 300 samples (three from each donor sample) were analyzed. Bacterial growth was found in 86 of the 100 samples before any pasteurization and one of the 100 postpasteurized samples without FoneAstra. None of the samples pasteurized using FoneAstra showed bacterial growth.
  
  
  CONCLUSIONS
  Both pasteurization methods were safe and effective. FoneAstra, however, provides the additional benefits of user-guided temperature monitoring and data tracking. By improving quality assurance and standardizing the pasteurization process, FoneAstra can support wide-scale implementation of human milk banks in resource-limited settings, increasing access and saving lives.
authors: 1 Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal , Durban, South Africa .
authors: Mageshree
authors: M
authors: Naicker
authors: Anna
authors: A
authors: Coutsoudis
authors: Kiersten
authors: K
authors: Israel-Ballard
authors: Rohit
authors: R
authors: Chaudhri
authors: Noah
authors: N
authors: Perin
authors: Koleka
authors: K
authors: Mlisana
mesh_terms: D003257:Consumer Product Safety; D003362:Cost-Benefit Analysis; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D017784:Milk Banks / Q000191:economics / Q000592:standards*; D008895:Milk, Human / Q000382:microbiology*; D061352:Pasteurization / Q000191:economics / Q000295:instrumentation / Q000379:methods; D011785:Quality Assurance, Health Care; D011786:Quality Control; D013019:South Africa