Vitamin content of breast milk from HIV-1-infected mothers before and after flash-heat treatment.
Kiersten A Israel-Ballard, Barbara F Abrams, Anna Coutsoudis, Lindiwe N Sibeko, Lynn A Cheryk, Caroline J Chantry
Author Information
Kiersten A Israel-Ballard: Department of Pediatrics, University of California, Davis Medical Center, 2516 Stockton Boulevard, Room 334, Sacramento, CA 95817, USA. ballardk@berkeley.edu
BACKGROUND: World Health Organization advocates heat treatment of expressed breastmilk (EBM) as one method to reduce postnatal transmission of human immunodeficiency virus (HIV) in developing countries. Flash-heat is a simple heat treatment method shown to inactivate cell-free HIV. OBJECTIVE: To determine the effect of flash-heat on vitamin content of milk. METHODS: Fresh EBM was collected from 50 HIV+ mothers in Durban, South Africa. Mothers washed their hands and then manually expressed 75-150 mL EBM into sterile jars. Milk was aliquoted to unheated controls or flash-heat (50 mL EBM in a glass jar heated in a 450-mL water jacket in an aluminum pan until water boiled, then EBM removed) simulating field conditions with an open flame. Samples were stored at -70 degrees C and then analyzed for the effect of flash-heat on vitamins [A, ascorbic acid, riboflavin (B2), pyridoxal-5-phosphate (B6), folate, and B12]. RESULTS: Vitamin A was not significantly affected by flash-heat and vitamins B12 and C and folate increased significantly. Vitamins B2 and B6 were decreased to 59% (95% confidence interval 44 to 81) and 96% (95% confidence interval 92 to 99), respectively, of that found in unheated milk. CONCLUSIONS: The percentage remaining after flash-heat suggests that most vitamin concentrations are retained after heating. Flash-heat may be a practical and nutritious infant feeding method for mothers in developing countries.
