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Canadian Journal of Public Health

, Volume 105, Issue 3, pp e218–e220 | Cite as

Specimen plastic containers used to store expressed breast milk in neonatal care units: A case of precautionary principle

  • Mélissa Blouin
  • Martin Coulombe
  • Marc Rhainds
Commentary

Abstract

Breast milk is the only milk that meets both the nutritional and immunitary needs of infants. Since breastfeeding is widely promoted, public health measures to preserve the nutritional qualities of expressed breast milk (EBM) should be applied in hospital care settings. The Health Technology Assessment Unit (HTAU) of the Centre hospitalier universitaire de Québec was requested by the Neonatal Care Unit to assess the acceptability of a plastic specimen container, designed to harvest tissues and body fluids, for storing collected EBM. An evidence-based public health perspective approach was taken to evaluate the safety of the specimen container. The HTAU recommended that plastic specimen containers no longer be used for storing EBM and that other options should be evaluated for neonatal care units. These recommendations are in accordance with the public health precaution principle and with legal considerations.

Key Words

Expressed breast milk storage plastic container neonatal care unit safety and chemical innocuity precautionary principle 

Résumé

Le lait maternel est le seul lait qui comble à la fois tous les besoins nutritionnels et immunitaires du nourrisson. Puisque la pratique de l’allaitement est fortement encouragée en milieu hospitalier, il importe d’appliquer correctement les mesures de santé publique en vigueur en matière de conservation du lait maternel exprimé. L’Unité d’évaluation des technologies et des modes d’intervention en santé (UETMIS) du CHU de Québec a été sollicitée par des cliniciens de l’unité néonatale afin d’évaluer l’acceptabilité d’utiliser pour la conservation du lait maternel exprimé, un contenant de plastique normalement prévu pour la collecte des tissus ou des fluides corporels. Dans cette démarche, une évaluation systématique des données probantes disponibles a été réalisée. L’UETMIS a recommandé de cesser l’utilisation du contenant actuel et d’envisager d’autres options pour la conservation du lait maternel exprimé à l’unité néonatale. Ces recommandations sont cohérentes avec l’application du principe de précaution utilisé en santé publique de même que des considérations d’ordre légales.

Mots Clés

lait maternel exprimé conservation contenant de plastique unité de soins néonatale sécurité et innocuité chimique principe de precaution 

References

  1. 1.
    Blouin M, Coulombe M, Rhainds M. Full technical report (in French): Évaluation des contenants utilisés pour la conservation du lait maternel exprimé en milieu hospitalier. Health and Technology Assessment Unit (HTAU), CHU de Québec, 2013. Poster (in English) presented at the 2013 Cochrane International Colloquium, Québec City, Québec, September 2013. Available at: http://www.chuqqcca/fr/evaluation/uetmis/ publications_uetmis/.Google Scholar
  2. 2.
    Gagnon, MP. Opportunities to Promote Efficiency in Hospital Decision-Making Through the Use of Health Technology Assessment. Canadian Health Services Research Foundation, 2011.Google Scholar
  3. 3.
    Chantry CJ, Howard, CR. Clinical protocols for management of breastfeeding. Pediatr Clin N Am 2013;60(1):75–113.CrossRefGoogle Scholar
  4. 4.
    Cossey V, Jeurissen A, Thelissen MJ, Vanhole C, Schuermans A. Expressed breast milk on a neonatal unit: A hazard analysis and critical control points approach. Am J Infect Control 2011;39(10):832–38.CrossRefGoogle Scholar
  5. 5.
    Eglash A, Bunik M, Chantry CJ, Howard CR, Lawrence RA, Marinelli KA, et al. ABM clinical protocol #8: Human milk storage information for home use for full-term infants (original protocol March 2004; Revision #1 March 2010). Breastfeed Med 2010;5(3):127–30.CrossRefGoogle Scholar
  6. 6.
    Jones F. Best Practice for Expressing, Storing and Handling Human Milk in Hospitals, Homes and Child Care Settings. Human Milk Banking Association of North America (HMBANA). 3rd edition, 2011.Google Scholar
  7. 7.
    Lawrence RA, Lawrence, RM. The collection and storage of human milk and human milk banking. In: Breastfeeding: A Guide for the Medical Profession. 7th edition, Elsevier Health Sciences, 2001.Google Scholar
  8. 8.
    Robbins ST, Meyers R; Pediatric Nutrition Practice Group. Infant Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 2nd edition. Academy of Nutrition and Dietetics, 2011.Google Scholar
  9. 9.
    Ministry of Justice. Food and Drugs Act (R.S.C. 1985, ch. F-27). Ottawa, ON: Government of Canada.Google Scholar
  10. 10.
    Ministry of Justice. Food and Drug Regulations (C.R.C., ch. 870). Division 23: Food Packaging Materials. Ottawa: Government of Canada.Google Scholar
  11. 11.
    Ministry of Justice. Canada Consumer Product Safety Act (S.C. 2010, ch. 21). Ottawa: Government of Canada.Google Scholar
  12. 12.
    Health Canada. Information Requirements for Food Packaging Submissions. Ottawa.Google Scholar
  13. 13.
    Health Canada. Health Products and Food Branch Packaging Materials Assessment Process. Ottawa.Google Scholar
  14. 14.
    Health Canada. Lists of Acceptable Polymers for Use in Food Packaging Applications. Ottawa.Google Scholar
  15. 15.
    Canadian Food Inspection Agency. Reference Listing of Accepted Construction Materials, Packaging Materials and Non-Food Chemical Products. Ottawa.Google Scholar

Copyright information

© The Canadian Public Health Association 2014

Authors and Affiliations

  • Mélissa Blouin
    • 1
  • Martin Coulombe
    • 1
  • Marc Rhainds
    • 1
  1. 1.Health Technology Assessment Unit, Department of Evaluation, Quality and Strategic PlanningCentre hospitalier universitaire (CHU) de Québec—Hôpital Saint-François d’AssiseQuébec CityCanada

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