Comparison of two methods for cleaning breast pump milk collection kits in human milk banks

Summary Background Appropriate decontamination of breast pump milk collection kits (BPK) is critical to obtain safe milk for infants and to avoid discarding donor human milk (DHM). Aim To evaluate two strategies for BPK decontamination by assessing microbial cultures and the proportion of discarded DHM, according to NICE criteria for pre-pasteurisation cultures. Methods Prospective comparative study, allocation ratio 1:1, microbiologist-blind. Participants: 47 new donors in a Human Milk Bank (Madrid). Interventions study group (n=21): washing the BPK with water and detergent after each use and further steam decontamination within a microwavable bag; control group (n=26): washing, rinsing and drying only. Five samples: first by hand expression and four additional samples (one per week) collected using the same pump and method. Outcomes Primary: proportion of DHM discarded due to contamination. Secondary: comparison of the microbiota between samples obtained by hand expression and breast pump in both groups. Findings 217 milk samples, 47 by hand expression and 170 by pump expression (78 from study group). Decontamination with a microwavable bag after washing the BPK resulted in a lower proportion of discarded DHM samples (1.3% vs 18.5%; p There were no differences in bacterial contamination between samples obtained by steam decontaminated kits and those obtained by hand expression. Conclusions Using a microwavable bag after washing the BPK decreases the amount of discarded DHM and the number of samples with potentially pathogenic bacteria.