Comparison of two methods for cleaning breast pump milk collection kits in human milk banks



      Appropriate decontamination of breast pump milk collection kits (BPKs) is critical to obtain safe milk for infants and to avoid discarding donor human milk (DHM).


      To evaluate two strategies for BPK decontamination by assessing microbial cultures and the proportion of discarded DHM, according to the criteria of the National Institute for Health and Care Excellence for pre-pasteurization cultures.


      Prospective comparative study, allocation ratio 1:1, microbiologist-blind.


      47 new donors in a human milk bank in Madrid.


      Study group (N=21): BPKs washed with water and detergent after each use and further steam decontamination within a microwavable bag. Control group (N=26): washing, rinsing and drying only. Five samples: first sample by hand expression and four samples (one per week) collected using the same pump and method.


      Primary: proportion of DHM discarded due to contamination. Secondary: comparison of the microbiota between samples obtained by hand expression and breast pump in both groups.


      In total, 217 milk samples were collected: 47 by hand expression and 170 by pump expression (78 from study group). Steam decontamination of BPKs using a microwavable bag after washing resulted in a lower proportion of discarded DHM samples (1.3% vs 18.5%, P<0.001) and samples contaminated with Enterobacteriaceae (1.3% vs 22.8%, P<0.001) and Candida spp. (1.3% vs 14.1%, P<0.05) compared with samples collected with BPKs that were washed but not steam decontaminated. There were no differences in bacterial contamination between samples obtained using steam decontaminated BPKs and those obtained by hand expression.


      Steam decontamination of BPKs using a microwavable bag after washing decreases the amount of discarded DHM and the number of samples with potentially pathogenic bacteria.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hospital Infection
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Moloney A.C.
        • Quoraishi A.H.
        • Parry P.
        • Hall V.
        A bacteriological examination of breast pumps.
        J Hosp Infect. 1987; 9: 169-174
        • D’Amico C.J.
        • DiNardo C.A.
        • Krystofiak S.
        Preventing contamination of breast pump kit attachments in the NICU.
        J Perinat Neonat Nurs. 2003; 17: 150-157
        • Bowen A.
        • Wiesenfeld H.C.
        • Kloesz J.L.
        • Pasculle A.W.
        • Nowalk A.J.
        • Brink L.
        • et al.
        Notes from the field: Cronobacter sakazakii infection associated with feeding extrinsically contaminated expressed human milk to a premature infant – Pennsylvania, 2016.
        MMWR Morb Mortal Wkly Rep. 2017; 66: 761-762
        • National Institute for Health and Care Excellence
        Donor milk banks: service operation. NICE guideline CG93.
        NICE, London2018 (Available at:) ([last accessed March 2019])
        • Gilks J.
        • Price E.
        • Hateley P.
        • Gould D.
        • Weaver G.
        Pros, cons and potential risks of on-site decontamination methods used on neonatal units for articles indirectly associated with infant feeding, including breast pump collection kits and neonatal dummies.
        J Infect Prev. 2012; 13: 16-23
        • Price E.
        • Weaver G.
        • Hoffman P.
        • Jones M.
        • Gilks J.
        • O`Brien V.
        • et al.
        Decontamination of breast pump milk collection kits and related ítems at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society and Infection Prevention Society.
        J Hosp Infect. 2016; 92: 213-221
        • Centers for Disease Control and Prevention
        How to keep your breast pump kit clean.
        CDC, Atlanta, GA2017 (Available at:) ([last accessed March 2019])
        • Picaud J.C.
        • Buffin R.
        • Gremmo-Feger G.
        • Rigo J.
        • Putet G.
        • Casper C.
        • et al.
        Review concludes that specific recommendations are needed to harmonise the provision of fresh mother's milk to their preterm infants.
        Acta Paediatr. 2018; 107: 1145-1155
        • Human Milk Banking Association of North America
        Guidelines for the establishment and operation of donor human milk bank.
        HMBANA, Fort Worth, TX2015
        • Calvo J.
        • García Lara N.R.
        • Gormaz M.
        • Peña M.
        • Martínez Lorenzo M.J.
        • Ortiz Murillo P.
        • et al.
        Recommendations for the creation and operation of maternal milk banks in Spain.
        An Pediatr (Barc). 2018; 89 (65.e1–6 [in Spanish])
        • Association des Lactariums de France
        Collection of breast milk.
        Association des Lactariums de France, Paris2016 (Available at:) ([last accessed March 2019] [in French])
        • Arslanoglu S.
        • Bertino E.
        • Tonetto P.
        • De Nisi G.
        • Ambruzzi A.M.
        • Biasini A.
        • et al.
        Guidelines for the establishment and operation of a donor human milk bank.
        J Matern Fetal Neonatal Med. 2010; 23: 1-20
        • Brazilian Network of Human Milk Banks
        Technical standards and manuals.
        Brazilian Network of Human Milk Banks, Rio de Janeiro2011 (Available at:) ([last accessed March 2019] [in Portuguese])
        • Becker G.E.
        • Smith H.A.
        • Cooney F.
        Methods of milk expression for lactating women.
        Cochrane Database System Rev. 2016; 9: CD006170
        • Pittard W.B.
        • Geddes K.M.
        • Brown S.
        • Mintz S.
        • Hulsey T.C.
        Bacterial contamination of human milk: container type and method of expression.
        Am J Perinatol. 1991; 8: 25-27
        • Boo N.Y.
        • Nordiah A.J.
        • Alfizah H.
        • nor-Rohaini A.H.
        • Lim V.K.E.
        Contamination of breast milk obtained by manual expression and breast pumps in mothers of very low birthweight infants.
        J Hosp Infect. 2001; 49: 274-281
        • Haiden N.
        • Pimpel B.
        • Assadian O.
        • Binder C.
        • Kreissl A.
        • Repa A.
        • et al.
        Comparison of bacterial counts in expressed breast milk following standard or strict infection control regimens in neonatal intensive care units: compliance of mothers does matter.
        J Hosp Infect. 2016; 92: 226-228
        • Serra V.V.
        • Teves S.
        • López de Volder A.
        • Ossorio F.
        • Aguilar N.
        • Armadans M.
        Comparison of the risk of microbiological contamination between samples of breast milk obtained at home and at a healthcare facility.
        Arch Argent Pediatr. 2013; 111: 115-119
        • Borges M.S.
        • Oliveira A.M.
        • Hattori W.T.
        • Abdallah V.O.S.
        Quality of human milk expressed in a human milk bank and at home.
        J Pediatr (Rio J). 2018; 94: 399-403
        • NHS
        Your pregnancy and baby guide. Expressing and storing breast milk.
        NHS, London2016 (Available at:) ([last accessed March 2019])