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Best Practices for Human Milk Collection for COVID-19 Research.

Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA. Division of Allergy and Immunology, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa. HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa. Department of Pediatrics and Child Health, University of Pretoria, Pretoria, South Africa. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy. Global Health Research Institute, Università Cattolica del Sacro Cuore, Rome, Italia. Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Valencia, Spain. Department of Food Science and Human Nutrition, University of Illinois, Urbana, Illinois, USA. Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany. College of Medicine, Section of Neonatal-Perinatal Medicine, Oklahoma City, Oklahoma, USA. Unidad de Investigación en Seguridad Alimentaria y Nutricional, Facultad de Ciencias Químicas y Farmacia Universidad de San Carlos de Guatemala, Guatemala City, Guatemala. School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Department of Nutritional Sciences, University of Toronto and Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada. Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Franc¸ais du Sang, CHU Montpellier, Montpellier, France.

Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. 2021;(1):29-38
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Abstract

In addition to providing life-giving nutrients and other substances to the breastfed infant, human milk can also represent a vehicle of pathogen transfer. As such, when an infectious disease outbreak, epidemic, or pandemic occurs-particularly when it is associated with a novel pathogen-the question will naturally arise as to whether the pathogen can be transmitted through breastfeeding. Until high-quality data are generated to answer this question, abandonment of breastfeeding due to uncertainty can result. The COVID-19 pandemic, which was in full swing at the time this document was written, is an excellent example of this scenario. During these times of uncertainty, it is critical for investigators conducting research to assess the possible transmission of pathogens through milk, whether by transfer through the mammary gland or contamination from respiratory droplets, skin, breast pumps, and milk containers, and/or close contact between mother and infant. To promote the most rigorous science, it is critical to outline optimal methods for milk collection, handling, storage, and analysis in these situations, and investigators should openly share their methods in published materials. Otherwise, the risks of inconsistent test results from preanalytical and analytical variation, false positives, and false negatives are unacceptably high and the ability to provide public health guidance poor. In this study, we provide "best practices" for collecting human milk samples for COVID-19 research with the intention that this will also be a useful guide for future pandemics.

Methodological quality

Publication Type : Review

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