13 Bio-Intimate Economies of Breastmilk ... 327of the anti-infectious properties of human milk. As human milk is a live
substance, factors such as maternal T cells, B cells, macrophages, and
neutrophils are inactivated when pasteurisation takes place. Secretary
IgA, lactoferrin, and lysozyme activity is reduced. Bile salt stimulated
lipase is also inactivated. This may cause reduced fat absorption. It is still
unclear whether pasteurisation affects oliogosaccharides (Akinbi et al.
2010 ; Ewaschuk et al. 2011 ).
As for the nutritional properties of donor milk following pasteurisa-
tion, it has been reported that protein, fat, and carbohydrate levels are
not affected. However, a recent study from Brazil (Vieira et al. 2011 )
has shown that there may be a modest decrease in the protein and fat
content of breastmilk when pasteurised, frozen, and thawed. There is an
emerging body of scientific literature documenting the effects of poten-
tially beneficial bacteria in breastmilk, as improved technology and
testing enables the detection of more bacteria. What the role these bac-
teria play in breastmilk has yet to be confirmed (Khodayar-Pardo et al.
2014 ).
HMBANA and NICE guidelines promote the use of donor screen-
ing and pasteurisation of donor milk. These guidelines are drawn from
blood donation and screening protocols. The screening of potential
donors takes into account lifestyle and health status, including medi-
cations, smoking, alcohol, blood transfusions, organ donation, risk of
Creutzfeldt-Jakob disease, chronic medical conditions, infections,
risk of STI’s, and any needle procedures indicating drug use. Blood is
screened for HIV 1 and HIV 2, HTLV 1 and HTLV 2, Hepatitis B,
Hepatitis C, Syphilis, and CMV.
Cytomegalovirus is a common and usually mild viral illness that
belongs to the herpes virus family (see Lawrence 2006 ). Occasionally,
CMV may be passed to an unborn infant if a mother develops CMV
during the early stages of pregnancy. The infant may also contract CMV
as they pass through the birth canal if the mother has CMV and breast-
milk/breastfeeding has been missed. In full term babies, this is not usu-
ally an issue, but for premature infants CMV may be transferred, causing
severe acute illness (Josephson et al. 2014 ). Freezing has been found to
decrease the level of CMV in breastmilk (Curtis et al. 2005 ). Due to the
fact that most babies receiving donor milk in the NICU are premature,