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    Pediatrics
    October 2013
    From the American Academy of Pediatrics
    Article

    Microbial Contamination of Human Milk Purchased Via the Internet

    Sarah A. Keim, Joseph S. Hogan, Kelly A. McNamara, Vishnu Gudimetla, Chelsea E. Dillon, Jesse J. Kwiek, Sheela R. Geraghty
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    Abstract

    OBJECTIVE: To quantify microbial contamination of human milk purchased via the Internet as an indicator of disease risk to recipient infants.

    METHODS: Cross-sectional sample of human milk purchased via a popular US milk-sharing Web site (2012). Individuals advertising milk were contacted to arrange purchase, and milk was shipped to a rented mailbox in Ohio. The Internet milk samples (n = 101) were compared with unpasteurized samples of milk donated to a milk bank (n = 20).

    RESULTS: Most (74%) Internet milk samples were colonized with Gram-negative bacteria or had >104 colony-forming units/mL total aerobic count. They exhibited higher mean total aerobic, total Gram-negative, coliform, and Staphylococcus sp counts than milk bank samples. Growth of most species was positively associated with days in transit (total aerobic count [log10 colony-forming units/mL] β = 0.71 [95% confidence interval: 0.38–1.05]), and negatively associated with number of months since the milk was expressed (β = −0.36 [95% confidence interval: −0.55 to −0.16]), per simple linear regression. No samples were HIV type 1 RNA-positive; 21% of Internet samples were cytomegalovirus DNA-positive.

    CONCLUSIONS: Human milk purchased via the Internet exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices. Infants consuming this milk are at risk for negative outcomes, particularly if born preterm or are medically compromised. Increased use of lactation support services may begin to address the milk supply gap for women who want to feed their child human milk but cannot meet his or her needs.

    • human milk
    • aerobic bacteria
    • Internet
    • infant
    • breastfeeding
  • Abbreviations:
    CFU —
    colony-forming unit
    CMV —
    cytomegalovirus
    FDA —
    US Food and Drug Administration
    GBS —
    group B streptococci
    HMBANA —
    Human Milk Banking Association of North America
    PCR —
    polymerase chain reaction
    • Accepted August 23, 2013.
    • Copyright © 2013 by the American Academy of Pediatrics
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    Microbial Contamination of Human Milk Purchased Via the Internet
    Sarah A. Keim, Joseph S. Hogan, Kelly A. McNamara, Vishnu Gudimetla, Chelsea E. Dillon, Jesse J. Kwiek, Sheela R. Geraghty
    Pediatrics Oct 2013, peds.2013-1687; DOI: 10.1542/peds.2013-1687

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    Microbial Contamination of Human Milk Purchased Via the Internet
    Sarah A. Keim, Joseph S. Hogan, Kelly A. McNamara, Vishnu Gudimetla, Chelsea E. Dillon, Jesse J. Kwiek, Sheela R. Geraghty
    Pediatrics Oct 2013, peds.2013-1687; DOI: 10.1542/peds.2013-1687
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