The impact of holder pasteurization on macronutrients, vitamins, minerals, and bioactive factors in human milk processed in a milk bank setting

Authors: DAVIS, AUTUMN - University Of North Carolina; LEE, SHERIDAN - University Of North Carolina; HAMPEL, DANIELA - University Of California, Davis; Shahab-Ferdows, Setareh; Allen, Lindsay; BODE, LARS - University Of California, San Diego; MANSEN, KIMBERLY - Path; ISRAEL-BALLARD, KIERSTEN - Path; PERRIN, MARYANNE - University Of North Carolina

Submitted to: Current Developments in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/14/2025
Publication Date: 7/24/2025
Citation: Davis, A., Lee, S., Hampel, D., Shahab-Ferdows, S., Allen, L.H., Bode, L., Mansen, K., Israel-Ballard, K., Perrin, M.T. 2025. The impact of holder pasteurization on macronutrients, vitamins, minerals, and bioactive factors in human milk processed in a milk bank setting. Current Developments in Nutrition. 9(8). Article 107490. https://doi.org/10.1016/j.cdnut.2025.107490.
DOI: https://doi.org/10.1016/j.cdnut.2025.107490

Interpretive Summary: Mothers milk from milk banks (DHM) is the preferred choice to feed preterm infants which are particularly susceptible to nutritional deficiencies.. Yet, we have little to no clear information on how pasteurization, a typically use technique for DHM, impacts the nutrients and immune factors present in the milk. Further, usually little thought was given to milk volume and equipment used in milk banks when investigating DHM before pasteurization; thus, resulting conclusions are not generally applicable. Therefore, we examined the effects of such Holder pasteurization -- performed accordingly to the milk banks protocol - on the concentrations of macronutrients, human milk oligosaccharides, vitamins, minerals, and antimicrobial proteins in human milk. We obtained 50 individual matched-pairs of raw and Holder-pasteurized milk from the Mothers’ Milk Bank of North Texas for testing the above mentioned nutrients and bioactive factors in the milk before and after pasteurization. We found that there was less than 15% loss of some nutrients, such as copper, calcium, vitamin B1, and non-protein nitrogen, up to 35% lower immunoglobin A concentrations (35%), and more than 80% reduction in lactoferrin (>80%) after pasteurization. Thus, we found that Holder pasteurization does not greatly affect human milk composition of the tested nutrients and bioactive factors. However, the noted heavy losses of antimicrobial proteins during the procedure warrants further research into alternative preservation techniques.

Technical Abstract: Background: Donor human milk is recommended for the nutritionally vulnerable preterm infant, yet there is conflicting or limited information on how the pasteurization techniques used on donor milk influence its nutritional and immune properties. Additionally, prior pasteurization studies were often not reflective of the volume and equipment used in milk bank settings, limiting their generalizability. Objective: Evaluate the impact of Holder pasteurization -- performed in a milk bank setting and using standardized preanalytical handling techniques -- on the composition of macronutrients, human milk oligosaccharides, vitamins, minerals, and antimicrobial proteins in human milk. Methods: Fifty matched-pairs of raw and Holder-pasteurized milk that were collected and pasteurized in a milk bank setting provided the sampling frame for this study. Each pair was from a unique, approved milk bank donor to the Mothers’ Milk Bank of North Texas. A total of 29 nutrients and bioactive factors were assessed using a variety of analytical methods. Results: There was evidence of minimal losses (<15%) in copper, calcium, thiamin, and non-protein nitrogen, moderate losses in immunoglobin A concentrations (35%), and extensive losses in lactoferrin (>80%). Conclusion: Holder pasteurization has limited to no impact on nutrients in donor milk including macronutrients, human milk oligosaccharides, B-vitamins, and minerals. Antimicrobial proteins incur moderate to heavy losses during Holder pasteurization which warrants research into alternative preservation techniques.