PEDIATRICS Vol. 47 No. 2 February 1971, pp. 456-459
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HUMAN MILK BANKING PRACTICES

William A. Silverman M.D.

On June 13, 1970, an informal meeting was held in San Francisco sponsored by the Mothers' Milk Bank to review current methods for collection, decontamination, and storage of human milk, in the light of evidence which has accumulated in the past few years. A number of problems were identified and several recommendations were made.

Chemical contamination of human milk was discussed at length and it was concluded that adulteration by ingested drugs is preventable by thorough screening of the donor's history and the advisement that all drugs (including unusual amounts of alcohol, aspirin, and coffee) be avoided by the donor.

Environmental contaminants, especially chlorinated hydrocarbons, are now ubiquitous and it is unrealistic to expect that all traces of these compounds will disappear (or can be removed easily) from human milk. It appears unlikely that avoidance of human milk significantly reduces the total amount of DDT in the body beyond early infancy, since human milk is not the primary source of this material; it is transmitted to the fetus across the placenta and is soon available to the child in other ingested foods (especially meat). No physiologic effects attributable to DDT have been described in infants fed human milk (e.g., amounts are considerably lower than needed for hepatic microsomal enzyme induction) and "tolerances" have not been established; nonetheless it is cheering to find that sporadic reports of measurements of DDT in human milk since 1951 give no evidence that there has been an increase in recent years (Table I).1-5 It was concluded that it is not necessary to monitor DDT concentration in the milk of individual donors (especially since day to day variations are quite small); however it was recommended that measurements be made of pooled samples at regular intervals to detect long-term trends.

Submitted on August 3, 1970
Accepted on September 21, 1970