There is no scientific evidence that guarantees the safety of powdered breast milk

The trend of turning frozen breast milk into powder so that it is practical is widely discussed. How is the safety guaranteed for babies?

KOMPAS/DHANANG DAVID

QR (21), a mother from Deli Serdang, North Sumatra, is giving formula milk to her one-month-old baby at her home on Wednesday (31/8/2022).

JAKARTA, KOMPAS — The Indonesian Pediatrician Association emphasizes that there is no scientific evidence that frozen breast milk dried into powder does not change its contents and is good for babies to consume. Recently, this information became a polemic on social media regarding its security.

Chair of the Breast Milk Task Force (ASI Task Force) of the Indonesian Pediatrician Association (IDAI), Naomi Esthernita Fauzia Dewanto, in a written statement , explains, the impact of freeze-drying important components of breast milk is currently still unknown.

However, considering the use of high temperatures during the freeze-dried breast milk drying process to remove water content, freeze-dried breast milk has an impact on the taste and quality of breast milk. This is the same as freezing breast milk which is commonly done in home practice.

The results of studies on freezing breast milk show that it triggers physical changes in the main components of breast milk, such as rupture of fat globules membranes and changes in casein micelles, as well as a decrease in the composition of protein bioactive factors with the length of frozen storage.

"Without adequate research evidence, it is not clear whether freeze-dried breast milk has the right ratio of protein, fat and carbohydrates as a source of important nutrients that babies need, as well as active substances for the baby's immunity and growth and development," said Naomi, in Jakarta, Friday (10/5/2024).

KOMPAS/BAHANA PATRIA GUPTA (BAH)

A mother and her malnourished child receive free food from the Community Movement for Stunting Care Program at the Asemrowo Subdistrict Office, Asemrowo District, Surabaya, East Java on Friday (3/12/2021).

The freeze-dried breast milk method is frozen into powder form, also known as the lyophilization technique, which is used to extend the shelf life of breast milk from six months in the freezer to three years. .

Users argue that it can save space for storing breast milk, provide comfort for mothers who often travel, and enable them to continue providing breast milk beyond their maternity leave.

So far, the CDC has only determined the method for storing breast milk by freezing. There are no guidelines for storing and using powdered breast milk.

This process involves freezing breast milk at an extreme temperature of minus (-) 50 Celsius for 3-5 hours, then transforming the frozen breast milk into powdered milk using the sublimation technique, which is the direct extraction of water in two days from solid (ice) to gas (water vapor) without a liquid phase.

Generally, one liter of breast milk will produce around 140 grams of breast milk powder. However, the freeze-dried method does not go through a pasteurization procedure which aims to kill dangerous bacteria. In this case, pasteurization is deliberately avoided to preserve the vital probiotics present in breast milk.

Thus, said Naomi, the risk of contamination remains a threat, especially when reconciling the addition of water to freeze-dried breast milk powder before being consumed by the baby.

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In addition, this method is a relatively new discovery. There is no proof yet through complete scientific research.

So far, there are no regulations or usage recommendations by health organizations such as the US Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), or the US Food and Drug Administration (FDA).

Therefore, IDAI still recommends a mother to breastfeed directly from the breast. Because breastfeeding directly from the breast can create close contact between mother and baby, foster a sense of security, and enhance the parent-child bond.

"Breastfeeding is not just about providing breast milk. Breastfeeding and pumping breast milk for babies may feel tiring, and it is understandable if the mother wants to find the easiest way to ensure the baby continues to receive breast milk," she said.

KOMPAS/BAHANA PATRIA GUPTA

Babies drink from bottles at the launch of the Healthy Toddler Competition at the Surabaya City Hall Yard, East Java, Wednesday (26/1/2022).

The IDAI ASI Task Force also warned all parties not to rashly promote or provide freeze-dried breast milk to babies, especially babies with certain medical conditions, such as premature, or babies who have immune disorders or chronic diseases.

"Because the active substances that are the superiority of breast milk are lost in the freeze-drying process. "This powdered milk product is not sterile in the manufacturing process, plus there is a risk of bacterial multiplication during storage," said Naomi.

Industries emerged

The Powdered breast milk trend has been around for a long time in several countries. In recent years a number of companies processing breast milk powder have emerged, such as Milkify, Booby-Licious, Booby Food, Milk by Mom, and Leche.

For example, Milkify states on its official website that drying breast milk into powder helps maintain the molecular structure of the milk. The company charges a few hundred US dollars depending on the weight to freeze-dry the milk and then ship it with insulated refrigeration.

"Researchers around the world have been studying this topic for decades and they agree that freeze-drying is a safe and effective way to maintain the nutritional, immunological, and probiotic content of breast milk, making it the gold standard of nutrition," wrote Milkify.

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However, the CDC has only specified a method for storing breast milk by freezing it. There are no guidelines for storing and using powdered breast milk.

The guidelines for storing and using frozen breast milk are that freshly pumped breast milk can last well for four hours at room temperature, 4 days in the refrigerator, and 6-12 months in the freezer.

The frozen breast milk to be used must be thawed for 1-2 hours on the table or 1 day in the refrigerator. The most important note is to never refreeze previously thawed breast milk. Any leftover milk that the baby does not consume is still good for consumption within 2 hours.