![]() ![]() For this reason, the European Association of Human Milk Banks (EMBA) recommends the research and establishment of alternative treatments to HoP. Unfortunately, this heat treatment has been shown to have a negative impact on some of the biologically active or nutritional compounds present in DHM. This treatment can be carried out in thermal baths with constant agitation or in validated semiautomatic pasteurizers designed for this purpose. At present, low-temperature long-time (heating at 62.5 ☌ for 30 min) pasteurization, also known as “Holder” pasteurization (HoP), is the heat treatment most commonly applied to DHM. To ensure microbiological safety, DHM is pasteurized in most HMBs to kill all non-spore forming and potentially pathogenic microorganisms. In addition, opening HMBs in neonatal units has been shown to increase breastfeeding rates. Additionally, NEC was associated with a US$66,015.00 higher cost per infant. found that MOM + DHM was associated with US$15,555.00 lower costs per infant ( p = .045). The use of DHM is associated with a reduction in the incidence of necrotizing enterocolitis (NEC), protection against late-onset sepsis and improved feeding tolerance compared to formula milk in this high-risk group of infants which in cost-effectiveness studies has resulted in significant economic savings. On these occasions, donor human milk (DHM) processed in human milk banks (HMBs) is the best alternative, especially for premature or sick newborns. However, there are situations in which the mother’s own milk (MOM) is not available or is in short supply to meet the nutritional requirements of the newborn. In addition, the promotion of breastfeeding is one of the strategies that minimizes economic losses for society with an estimated potential savings for the Spanish National Health System of more than 5.6 million euros for each percentage point increase in exclusive breastfeeding rates in Spain during 2014. There are numerous studies on the benefits attributed to breastfeeding for the health of the mother and the development of the newborn in both the short and long term. HTST pasteurization requires a high initial investment in equipment however, it provides a significant minimization of production costs in the long term, pasteurizes large quantities of donor milk per working day and achieves a more efficient management of the time of the health care professionals in charge of the bank’s operation compared to HoP.īreastfeeding is the optimal type of feeding for newborns during the first six months of life. In scenario 3, the unit cost of milk pasteurized by the HTST method decreased from the first to the second year by 43.5%, while for the HoP method, it decreased by 30%. The cost of healthcare professionals was reduced by more than half when pasteurization was carried out by the HTST method versus the Holder method (€ 84.00 and € 191.00, respectively). In scenario 2, these costs were similar (€ 6,594.00 for HTST pasteurization versus € 5,912.00 for HoP). In scenario 1, the total production costs were € 228,097.00 for the HTST method versus € 154,064.00 for the HoP method. The following costs were analyzed: health care professionals, equipment and software, external services, and consumables. Total production costs (fixed plus variables) were quantified using HTST pasteurization and HoP in three hypothetical scenarios: (1) costs of the first 10 L of pasteurized milk in a newly opened milk bank (2) costs of the first 10 L of pasteurized milk in an active milk bank and (3) costs using the maximum production capacity of both technologies in the first two years of operation. MethodsĪ cost-minimization study was carried out on the facilities of a regional human milk bank in a public hospital. HTST pasteurization guarantees the milk’s microbiological safety and retains more of its biologically and nutritionally active compounds, but the cost of implementing this technology for a human milk bank is unknown. High-temperature short-time (HTST) pasteurization (72–75 ☌, 15 s) is an alternative treatment to traditional Holder pasteurization (HoP) (62✬, 30 min) for donor milk. ![]()
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