Cariogenic Potential of Stored Human Milk The Journal of Clinical Pediatric Dentistry Volume 32, Number 1/2007 27 INTRODUCTION E xclusive breastfeeding is the preferred method of infant feeding in the first six months of life, and con- tinued breastfeeding throughout the first year and into the second year carries with it a multitude of advantages for both the mother and the infant. 1,2,3,4, The numerous advantages offered by breast milk when compared to animal milk and formulas include nutritional superiority, cost effectiveness, rapid growth and develop- ment of infant, immune protection and protection from allergies. 5 Human milk most often goes directly from producer to consumer. However, the need to store breast milk for at least limited periods of time is unavoidable in a neonatal unit tak- ing care of sick and preterm new-born infants. In preterm neonates, the mother’s milk may not be adequately con- sumed due to inadequate suckling stimulation by the weak neonate. 6 In addition, some mothers may not be able to nurse their babies due to reasons pertaining to mental or physical illness, marital discord or other personal reasons. In all such cases, storage of breast milk followed by frequent feeding becomes important. Milk may be either stored in milk banks or stored at home or workplaces in refrigerators following specific storage guidelines. 7 Nursing caries is a frustrating condition which is difficult to treat in infants and very young children. It can be painful, is infectious, and results in impairment of nutrition and esthetics with accompanying psychological problems. 8 Pro- longed and excessive breastfeeding has been suspected as a causative factor in early childhood caries. 1,9,10,11,12,13,14,15,16 Freshly expressed human milk was found to have pH in the range of 6.56 and 7.2. 6,17 It was reported that pH of human breast milk progressively falls during storage. 6 Buffer capacity of any liquid is the quantity of strong acid or base that must be added to change the pH of one liter of solution by one pH unit. 18 Buffer capacity of HBM was found to be very poor. 19 Many bacteriological studies have concentrated on exam- ining the changes occurring in the breast-milk stored by refrigeration. 6 Little or no research has been done on the car- iogenic potential of the stored human milk. Hence, the pre- sent study was undertaken to investigate the cariogenic potential of human milk stored at various temperatures by studying the pH, buffer capacity and microbial growth. MATERIALS AND METHODS Consent was obtained from ten healthy lactating mothers in KSHEMA Hospital, Mangalore, who had deliveries 5 to 7 days previously. Mothers who were diagnosed with systemic diseases and mothers who were under medications were excluded from the study. The nipples and the tissue around it were cleaned with 0.2% chlorhexidine solution using sterile cotton swab with gloved hands to prevent contamination. 20,21 It was wiped off Cariogenic Potential of Stored Human Milk—An In-Vitro Study Amitha M. Hegde. */ Rani Vikyath** Human milk samples collected from ten lactating mothers in the K. S. Hegde Medical Hospital, Mangalore were divided into five different parts and stored at different temperatures for varying durations. The pH, buffer capacity and growth of Streptococcus mutans were assessed in each of these samples. There was a fall in pH of human milk stored at various temperatures. The buffer capacity of human milk increased with dura- tion of storage. There was an increase in Streptococcus colony count in stored human milk proportional to the duration of storage and it increased more rapidly in case of milk stored at higher temperatures (0ºC - 4ºC) compared to the milk stored in the freezer (-19ºC). Milk samples stored at room temperature for 6 hours and in the freezer at -19ºC for 2 weeks were found to be relatively safe. Key Words: Human milk, Storage, Cariogenic potential, pH, Buffer capacity, Streptococcus mutans. List of Abbreviations: HBM- Human breast milk; Sm- Streptoccus mutans J Clin Pediatr Dent 32(1): 27–32, 2007 * Dr. Amitha M. Hegde, Professor and Head of the Department of Pedodontics and Preventive Children Dentistry, A. B. Shetty Memorial Institute of Dental Sciences ** Dr. Rani Vikyath Post graduate student, Department of Pedodontics and Preventive Children Dentistry, A. B. Shetty Memorial Institute of Dental Sciences Send all correspondence to Dr. Amitha M. Hegde, Professor and Head of the Department, Department of Pedodontics and Preventive Children Den- tistry, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore-575018, Karnataka, India. Fax no: +91-824-2204572 \ 2224440. Email: amipedo@yahoo.co.in Downloaded from http://meridian.allenpress.com/jcpd/article-pdf/32/1/27/1745192/jcpd_32_1_04823467j4570681.pdf by Bharati Vidyapeeth Dental College & Hospital user on 23 July 2022