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J Acquir Immune Defic Syndr. 2009 Jul 1;51(3):264-7. doi: 10.1097/QAI.0b013e3181aa12f2.

Effect of flash-heat treatment on immunoglobulins in breast milk.

Author information

  • 1Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA. caroline.chantry@ucdmc.ucdavis.edu

Abstract

BACKGROUND:

Heat-treated expressed breast milk is recommended by the World Health Organization as an option to reduce vertical HIV transmission in resource-poor regions. Flash-heat (FH) is a low technology pasteurization method developed for home use, but its effect on quantity and quality of breast milk immunoglobulins is unknown.

OBJECTIVE:

To evaluate FH's effect on breast milk immunoglobulin levels and antigen-binding capacity.

DESIGN/METHODS:

Fifty HIV+ mothers in South Africa provided breast milk. Part of each sample served as an unheated control; the remainder was flash-heated. Total and antigen-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) were measured by enzyme-linked immunosorbent assay. Paired t test was performed on log-transformed data.

RESULTS:

FH significantly decreased total IgA and IgG concentrations [geometric mean (geometric SD) 318.0 (1.9) vs. 398.2 (1.9) microg/mL and 89.1 (2.7) vs. 133.3 (2.5) microg/mL, P < 0.001 each]. Similar decreases in anti-HIV-1 gp120 IgG, anti-pneumococcal polysaccharide, and anti-poliovirus IgA occurred (P < 0.001 each). Although the latter was most affected, FH retained 66% of the antigen-binding ability. In contrast, binding capacity of IgA and IgG to influenza increased after FH (P = 0.029 and 0.025, respectively).

CONCLUSIONS:

Most breast milk immunoglobulin activity survives FH, suggesting flash-heated breast milk is immunologically superior to breast milk substitutes. Clinical significance of this decreased immunoglobulin activity needs evaluation in prospective trials.

PMID:
19421069
[PubMed - indexed for MEDLINE]
PMCID:
PMC2779733
Free PMC Article

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