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<jats:p> The use of human milk in milk banks requires thermal processing to eliminate microbiological hazards. An evaluation is made of the stability of overall human milk bactericidal capacity following 2 modalities of thermal pasteurization: 63°C/30 minutes and 75°C/15 seconds. Ten milk samples (mature milk) were analyzed. In each sample, the effect of both thermal treatments on bactericidal capacity against Escherichia coli was evaluated in relation to the capacity of fresh milk (control). All the samples analyzed possessed bactericidal capacity. Human milk pasteurization induced a significant loss of this capacity that was more pronounced after high-temperature treatment than after low-temperature processing. Untreated milk, low-pasteurized milk, and high-pasteurized milk yielded a reduction in E. coli growth of 70.10%, 52.27%, and 36.39%, respectively. In conclusion, human milk possesses antimicrobial activity that is lost in part as a result of thermal processing. Such bactericidal capacity is, moreover, better preserved by low-temperature, long-time pasteurization. J Hum Lact. 24(4):371-376. </jats:p>

<jats:sec><jats:title>Background:</jats:title><jats:p> Physicians’ attitudes and recommendations directly affect breastfeeding duration. Yet, studies in many nations have shown that physicians lack the skills to offer proper guidance to breastfeeding mothers. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> This study aims to assess breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> A breastfeeding questionnaire was developed and piloted prior to study enrollment. These questionnaires were sent to 1429 pediatricians (PED), 1329 family physicians (FP), and final-year pediatric and final-year family medicine residents (PR and FMR). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The analysis included 397 PED, 322 FP, 17 PR, and 44 FMR who completed the questionnaire. Mean overall correct knowledge score was 67.8% for PED, 64.3% for FP, 72.7% for PR, and 66.8% for FMR. Two hundred eighty-five PED (74.2%), 228 FP (73.1%), 7 PR (41.2%), and 21 FMR (53.8%) felt confident with their breastfeeding counseling skills. Less than half (49.6% of PED and 45.4% of FP) believed that evaluating breastfeeding was a primary care physician’s responsibility, and few PED or FP (5.1% and 11.3%) routinely observed breastfeeding in mother-infant pairs. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Several areas of potential deficits were identified in Canadian physicians’ breastfeeding knowledge. Physicians would benefit from greater education and support, to optimize care of infants and their mothers. </jats:p></jats:sec>

<jats:sec><jats:title>Background:</jats:title><jats:p> The most utilized pasteurization method in donor human milk banks is Holder pasteurization (heating 62.5 °C for 30 min). However, many bioactive proteins are heat sensitive and are inactivated. </jats:p></jats:sec><jats:sec><jats:title>Research Aim:</jats:title><jats:p> To determine the results of a range of heating regimes on the activities of xanthine oxidase, lactoperoxidase and lysozyme, the concentrations of immunoglobulin A and lactoferrin, as well as bacterial inactivation. </jats:p></jats:sec><jats:sec><jats:title>Method:</jats:title><jats:p> This prospective, cross-sectional, intervention study was designed to measure the influence of heating temperatures on bioactive components in donor human milk. Milk samples were processed at 40, 50, 55, 62.5, 75, 127 °C and the activities of the enzymes, and the concentration of immune proteins, were measured. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> No bacterial colonies were detectable, using standard culture methods, after heating above 50 ºC. All proteins studied retained over 60% concentrations or activities when the pasteurization temperature was 50 ºC or lower, while their concentrations or activities were lost at higher temperatures. For lactoferrin, the residual concentration was above 80% when heating temperature was under 55 °C, while only 20% remained after Holder pasteurization. Both xanthine oxidase and lactoperoxidase had little residual activity when temperatures were above Holder pasteurization. Lysozyme retained a greater proportion of residual activity than other proteins, following heating at all temperatures. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> The concentrations or activities of immune proteins and bioactive enzymes decreased when heated above 50 °C. The results of this study can be used to design temperature control guidance during alternative methods of pasteurization. </jats:p></jats:sec>