Human milk banks: lights and shadows

Breastfeeding is the most appropriate source of nutrition also for preterm infants. When mother’s own milk is not available, donor human milk (DHM), provided from a human milk bank (HMB), or formula can be used. Infants fed DHM grow at a slower rate than formula-fed infants. However, DHM has the advantage over formula to retain some of the bioactive properties of naïve human milk. Given the wide variability of DHM content and its generally low macronutrient content, individualised fortification represents a more valid option than standard fortification in order to meet the high nutritional requirements of preterm infants. Pasteurization is necessary to reduce bacterial count in DHM. Holder pasteurization, which is recommended in most HMB guidelines, has several limitations, because it impairs macronutrient and functional components of DHM. Alternative methods of pasteurization, which would be capable of retaining the bioactive properties of DHM with the highest level of microbiological safety, are currently under investigation