Christine asks what treatment, if any, is given to donor milk here in Norway
before being fed to premature infants.
Donors are selected, excluding mothers on virtually any medication, and
users of tobacco in any form.  They are tested as for giving blood, and in
particular their CMV status is of interest.  CMV positive mothers may donate
milk, but the tiniest most immature babies are never given that milk from
the bank, though I believe that if the baby's mother is CMV positive, the
baby gets her milk anyway.
The milk is frozen by the donor mothers as it is collected.  Each unit of
milk delivered to a bank is tested for bacteria count.  Once it has passed
the bacteria test, it is held frozen until just before use.  If it doesn't
pass the bacteria test it is returned to the mother because it is felt that
it is safe for her own healthy child to drink it.

Fortifier is added for babies under a certain age/weight and I can never
remember what those limits are.  I don't work directly with babies in
intensive care myself; the closest I get to them is caring for their mothers
in the first week or so after birth.  Babies who are big and old enough to
go home from the hospital are NEVER on fortifier.

Donor milk is not pasteurized because we really want babies to benefit from
all the properties of human milk, not just the nutritional and indirectly
protective properties.

Once mothers have their own supplies going, the milk is given to the baby
fresh, and is not routinely tested for bacteria.  If the mother or the baby
gets an MRSA infection, they test everything, but not otherwise.

Rachel Myr
Kristiansand, Norway

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