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Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases

Chelsea S. Amenah‐James, Ellen W. Evans Orcid Logo, Sophia Komninou Orcid Logo

Comprehensive Reviews in Food Science and Food Safety, Volume: 24, Issue: 5, Start page: e70282

Swansea University Author: Sophia Komninou Orcid Logo

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DOI (Published version): 10.1111/1541-4337.70282

Abstract

Infant feeding influences infant growth, development, survival, and long-term health. Maternal expressed breast milk (MEBM), donor human milk (DHM), and powdered infant formula (PIF) serve as alternatives when direct breastfeeding is not feasible. However, these alternatives are susceptible to micro...

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Published in: Comprehensive Reviews in Food Science and Food Safety
ISSN: 1541-4337 1541-4337
Published: Wiley 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70321
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spelling 2025-10-21T15:48:11.3652575 v2 70321 2025-09-08 Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases ae112e20f29a2a4b0acdfb3abb2ec6a9 0000-0002-3835-8302 Sophia Komninou Sophia Komninou true false 2025-09-08 HSOC Infant feeding influences infant growth, development, survival, and long-term health. Maternal expressed breast milk (MEBM), donor human milk (DHM), and powdered infant formula (PIF) serve as alternatives when direct breastfeeding is not feasible. However, these alternatives are susceptible to microbial contamination, posing risks of infection and mortality. Despite concerns about foodborne infections in neonates, no comprehensive synthesis has examined infections and deaths directly linked to contaminated infant milk across different feeding methods. This scoping review examines infections and deaths associated with contaminated MEBM, DHM, and PIF in high-income countries over the past 25 years, identifying key pathogens and sources of contamination. A systematic search on Medline, Scopus, and Embase identified a total of 6867 studies, of which 19 were selected, with an additional study from references. Data extracted for feeding type, pathogen, contamination source, and clinical outcomes. Among 175 cases, 55 led to systemic infections, including 13 deaths. Cronobacter sakazakii and Pseudomonas aeruginosa were the most frequently implicated pathogens in the published papers. PIF and DHM were more often linked to infections than MEBM. Besides intrinsic PIF contamination, hospital milk blenders and dishwashers were found to be positive for pathogens. DHM cases reported positive cultures of the nasogastric tubes, milk bank pasteurizers, and hospital bottle warmers. MEBM contamination was reported through breast pumps and hospital sinks and drains. This review highlights the need for enhanced hygiene protocols in handling infant milk. These findings inform clinical and public health policies aimed at minimizing infection risks associated with alternative infant feeding methods. Journal Article Comprehensive Reviews in Food Science and Food Safety 24 5 e70282 Wiley 1541-4337 1541-4337 bacterial contamination, breast milk, donor human milk, foodborne infection, infant feeding, infant mortality, powdered infant formula 19 9 2025 2025-09-19 10.1111/1541-4337.70282 Comprehensive Review COLLEGE NANME Health and Social Care School COLLEGE CODE HSOC Swansea University SU Library paid the OA fee (TA Institutional Deal) Swansea University 2025-10-21T15:48:11.3652575 2025-09-08T10:25:48.2850518 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Chelsea S. Amenah‐James 1 Ellen W. Evans 0000-0002-1523-1480 2 Sophia Komninou 0000-0002-3835-8302 3 70321__35424__c55c24ed44db4a6d9ceecb90e7eb4d93.pdf 70321.VOR.pdf 2025-10-21T15:43:46.3542390 Output 604400 application/pdf Version of Record true © 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License (CC BY). true eng http://creativecommons.org/licenses/by/4.0/
title Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
spellingShingle Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
Sophia Komninou
title_short Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
title_full Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
title_fullStr Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
title_full_unstemmed Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
title_sort Foodborne Infections and Mortality Associated With Expressed Breastmilk, Donated Breastmilk, and Infant Formula in High‐Income Countries: A Scoping Review of Peer‐Reviewed Evidence Cases
author_id_str_mv ae112e20f29a2a4b0acdfb3abb2ec6a9
author_id_fullname_str_mv ae112e20f29a2a4b0acdfb3abb2ec6a9_***_Sophia Komninou
author Sophia Komninou
author2 Chelsea S. Amenah‐James
Ellen W. Evans
Sophia Komninou
format Journal article
container_title Comprehensive Reviews in Food Science and Food Safety
container_volume 24
container_issue 5
container_start_page e70282
publishDate 2025
institution Swansea University
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doi_str_mv 10.1111/1541-4337.70282
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description Infant feeding influences infant growth, development, survival, and long-term health. Maternal expressed breast milk (MEBM), donor human milk (DHM), and powdered infant formula (PIF) serve as alternatives when direct breastfeeding is not feasible. However, these alternatives are susceptible to microbial contamination, posing risks of infection and mortality. Despite concerns about foodborne infections in neonates, no comprehensive synthesis has examined infections and deaths directly linked to contaminated infant milk across different feeding methods. This scoping review examines infections and deaths associated with contaminated MEBM, DHM, and PIF in high-income countries over the past 25 years, identifying key pathogens and sources of contamination. A systematic search on Medline, Scopus, and Embase identified a total of 6867 studies, of which 19 were selected, with an additional study from references. Data extracted for feeding type, pathogen, contamination source, and clinical outcomes. Among 175 cases, 55 led to systemic infections, including 13 deaths. Cronobacter sakazakii and Pseudomonas aeruginosa were the most frequently implicated pathogens in the published papers. PIF and DHM were more often linked to infections than MEBM. Besides intrinsic PIF contamination, hospital milk blenders and dishwashers were found to be positive for pathogens. DHM cases reported positive cultures of the nasogastric tubes, milk bank pasteurizers, and hospital bottle warmers. MEBM contamination was reported through breast pumps and hospital sinks and drains. This review highlights the need for enhanced hygiene protocols in handling infant milk. These findings inform clinical and public health policies aimed at minimizing infection risks associated with alternative infant feeding methods.
published_date 2025-09-19T05:32:21Z
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