Wesolowska et al., 2019(1414 Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB. Innovative techniques of processing human milk to preserve key components. nutrients. 2019;11(5). doi: 10.3390/nu11051169 https://doi.org/10.3390/nu11051169...
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To compare HM pasteurization methods to improve the safety and quality of donated milk. |
Critical analysis |
HPP and ultraviolet-C irradiation methods seem to minimize losses as a result of HM processing. |
Hartmann, 2017(1515 Hartmann BT. Ensuring safety in donor milk banking in neonatal intensive care. Clin Perinatol. 2017;44(1):131-49. doi: 10.1016/j.clp.2016.11.006 https://doi.org/10.1016/j.clp.2016.11.00...
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To assess the risks and benefits for HMB donors and recipients using a systematic method. |
Risk management - HACCP |
Potential hazards and benefits are identified at each stage of HMB processes, and the minimum acceptable standard for safe practice is defined. |
Peila et al., 2017(1616 Peila C, Emmerik NE, Giribaldi M, et al. Human milk processing: a systematic review of innovative techniques to the ensure safety and quality of donor milk. J Pediatr Gastroenterol Nutr. 2016;64(3):353-61. doi: 10.1097/mpg.0000000000001435 https://doi.org/10.1097/mpg.000000000000...
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To assess the evidence on the effectiveness of new pasteurization techniques on the quality and safety of HM |
Critical analysis |
The HTST method showed equivalence to the standard pasteurization method, guaranteeing the microbiological safety of HM. |
Grazziotin et al., 2016(1717 Grazziotin MCB, Grazziotin AL, Vidal NM, Freira MHS, Silva RPGVC. Analysis of the storage methods for raw human milk from mothers with infants admitted to a neonatal intensive care unit, according to Brazilian Regulations, J Hum Lact. 2016;32(3):446-54. doi: 10.1177/0890334416647710 https://doi.org/10.1177/0890334416647710...
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To assess the evidence on the raw HM storage protocol according to Brazilian regulations. |
Critical analysis |
The methods of storage in refrigeration (5°C/12 hours) and freezing (20°C/15 days) were validated and the energy content of milk was preserved. |
Naicker et al., 2015(1818 Naicker M, Coutsoudis A, Israel-Ballard K, Chaudhri R, Perin N, Mlisana K. Demonstrating the efficacy of the foneastra pasteurization monitor for human milk pasteurization in resource-limited settings. Breastfeed Med. 2015;10(2):107-12. doi: 10.1089/bfm.2014.0125 https://doi.org/10.1089/bfm.2014.0125...
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To assess the safety and effectiveness of a mobile pasteurization monitor, FoneAstra, based on Smartphone, as a quality control system for the pasteurization process. |
Information technology |
None of the samples pasteurized using FoneAstra showed bacterial growth. The innovative tool proved to be safe, effective and low cost for HM pasteurization. |
De Nisi et al., 2015(1919 Nisi G, Moro GE, Arslanoglu S, Ambruzzi AM, Biasini A, Profeti C, et al. Survey of Italian human milk banks. J Hum Lact. 2015;31(2):294-300. doi: 10.1177/0890334415573502 https://doi.org/10.1177/0890334415573502...
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To compare the operating procedures of 28 Italian HMB to identify areas of strength and improvement. |
Benchmarking |
Divergence in the structure (number of hours worked, number of rooms and number of equipment), in the selection processes and mandatory microbiological control. |
ME Maes et al., 2015(2020 Maes ME, Possamai MT, Assoler MG, Sardá FAH. Sistema APPCC em banco de leite humano, Hig Alim [Internet]. 2015 [2017 Marc 03];29:248-9. Available from: https://www.academia.edu/19465644/SISTEMA_APPCC_EM_BANCO_DE_LEITE_HUMANO https://www.academia.edu/19465644/SISTEM...
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To manage risk and control food safety hazards at HMB. |
Risk management - HACCP |
The critical points were identified: 6 prevented (CCPp), 4 eliminated (CCPe) and 1 reduced (CCPr), which made corrective actions possible. |
Menezes et al., 2014(2121 Menezes G, Lima-Cavalcanti L, Morais-Oliveira AM, Costa-Pinto RM, Steffen-Abdallah VO. Evaluation of home collection performed by a human milk bank in a university hospital in Brazil. Salud Publica Mex [Internet]. 2014 [2017 Marc 03];56(3):245-50. Available from: https://www.researchgate.net/publication/266381549_Evaluation_of_home_collection_performed_by_a_human_milk_bank_in_a_university_hospital_in_Brazil https://www.researchgate.net/publication...
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To assess home collection and transport of raw HM during home visits. |
Checklist |
Weaknesses in the collection process were identified, such as hair protection (93.8%), hand hygiene (83.3%), nail care (87.5%) and neglecting the first drops (33.3%). |
Brownell et al., 2014(2222 Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA. Donor human milk bank data collection in North America: an assessment of current status and future needs. J Hum Lact. 2014;30(1):47-53. doi: 10.1177/0890334413508237 https://doi.org/10.1177/0890334413508237...
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To monitor data from HMBANA belonging to HMBANA, on the characteristics of the donor and donated milk, the feasibility and the interest in participating in a central registry. |
Information technology |
There was no uniformity in the data collected. A lack of standardization and transparency of information was identified. |
Spatz et al., 2014(2323 Spatz DL, Schmidt KJ, Kinzler S. Implementation of a human milk management center. Adv Neonatal Care. 2014;14(4):253-61. doi: 10.1097/ANC.0000000000000084 https://doi.org/10.1097/ANC.000000000000...
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To analyze the key activities in the implementation of an HM management center in a children's hospital. |
Flow mapping |
Structural weaknesses, the need to improve processes, change in local culture, training of teams and periodic assessment of results were identified. |
Carroll, 2014(2424 Carroll K. Body dirt or liquid gold? how the “safety” of donated breast milk is constructed for use in neonatal intensive care. Soc Stud Sci. 2013;44(3)466-85. doi: 10.1177/0306312714521705 https://doi.org/10.1177/0306312714521705...
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To draw the flow of the donated HM of two HMB, from selection to distribution and assess the the process safety. |
Flow mapping |
The variety of practices and security process in the selection and education of donors, pasteurization and microbiological analysis of the HM between the two HMB were identified. |
Vieczorek & Wolff, 2012(2525 Vieczorek A, Wolff L. Evaluation of human milk banks in Paraná - Br: a comparative study. O Braz J Nurs. 2012;11(1). doi: 10.5935/1676-4285.20120009 https://doi.org/10.5935/1676-4285.201200...
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To compare the structure and processes of 8 HMB paranaense based on RDC 171/2006 and ANVISA's HMB operating manual. |
Benchmarking |
The weak and strong points in the eight HMB were identified. The percentage of compliance ranged from 72 to 85% and non-compliance showed an average of 21%. |
Torrezan, 2011(2626 Torrezan AC. Gestão do processo assistencial e de processamento de Banco de Leite Humano com foco na melhoria da qualidade [Dissertação]. Instituição de Ensino: Universidade Federal de São Carlos, São Carlos; 2010[2017 Jun 07]. Available from: https://repositorio.ufscar.br/handle/ufscar/3224?show=full https://repositorio.ufscar.br/handle/ufs...
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To implement the Process Management methodology in HM assistance and processing activities. |
Flow mapping PDCA Benchmarking |
All stages were known and an action plan to improve and monitor all processes was implemented. |
Grazziotin et al., 2010(2727 Grazziotin AL, Grazziotin MCB, Letti LAJ. Disposal of human milk donated to a human milk bank before and after measures to reduce the amount of milk unsuitable for consumption. J Pediatr. 2010;86(4):290-4. doi: 10.2223/JPED.2014 https://doi.org/10.2223/JPED.2014...
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To assess the causes of disposal of the donated HM and the impact of the implemented measures. |
Checklist |
The causes of disposal were identified and showed a positive impact in reducing the volume of discarded donated milk. |
Silva, 2009(2828 Silva JHF. Inovações tecnológicas para uma estratégia de qualificação dos produtos e dos processos de trabalho em Bancos de Leite Humano: o sistema de gerenciamento BLHWEB. [Dissertação] [Internet]. Escola Nacional de Saúde Pública Sergio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro; 2009 [2017 Jun 07]; Available from: https://www.arca.fiocruz.br/handle/icict/2442 https://www.arca.fiocruz.br/handle/icict...
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To know the technological innovations produced by the HMBWEB system in the qualification of HMB performance. |
Information system |
Construction of indicators that qualify HMB management, processes and procedures. |
Silva et al., 2008(2929 Silva ER, Abdallah VOS, Oliveira AMM. Qualidade microbiológica do leite humano ordenhado no domicílio: eficácia de uma ação educativa. In 5ª Semana Acadêmica Universidade Federal de Uberlândia, [Internet]. 2008 [2017 Jun 01]. Available from https://ssl4799.websiteseguro.com/swge5/seg/cd2008/pdf/sa08-21093.pdf https://ssl4799.websiteseguro.com/swge5/...
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To compare the physical-chemical and microbiological quality of raw HM at home and at HMB before and after a new educational action. |
Educational action |
There was no improvement in relation to Dornic acidity and microbiological analysis after educational actions. |
Costa et al., 2003(3030 Costa ACM, Pereira DCA, Silva JAR, Silva Neto JP, Britto MHSS. Avaliação da qualidade dos bancos de leite humano no município de São Luis-Ma, no período de abril a junho de 2003. Rev Hosp Univ UFMA [Internet]. 2003 [2017 Jun 01];38. http://www2.ebserh.gov.br/documents/16424/491465/Revista_HU_Volume_4_3_SET_DEZ_2003.pdf/181a1c18-30e3-4518-9da3-e7359649fced http://www2.ebserh.gov.br/documents/1642...
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To compare the structure, processes and results of two HMB in the city of São Luís, state of Maranhão. |
Benchmarking |
Divergences were identified regarding the physical, organizational and process control structures that compromise the quality of the product. |