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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 and Sheela R. Geraghty
Pediatrics November 2013, 132 (5) e1227-e1235; DOI: https://doi.org/10.1542/peds.2013-1687
Sarah A. Keim
aCenter for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio;
Departments of bPediatrics,
cDivision of Epidemiology, and
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Joseph S. Hogan
dAnimal Sciences,
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Kelly A. McNamara
aCenter for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio;
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Vishnu Gudimetla
eMicrobial Infection and Immunity, and
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Chelsea E. Dillon
aCenter for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio;
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Jesse J. Kwiek
eMicrobial Infection and Immunity, and
fMicrobiology, The Ohio State University, Columbus, Ohio; and
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Sheela R. Geraghty
gCincinnati Children’s Center for Breastfeeding Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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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
  • Accepted August 23, 2013.
  • Copyright © 2013 by the American Academy of Pediatrics

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Pediatrics
Vol. 132, Issue 5
1 Nov 2013
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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 Nov 2013, 132 (5) e1227-e1235; 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 Nov 2013, 132 (5) e1227-e1235; DOI: 10.1542/peds.2013-1687
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