Effect of flash-heat treatment on immunoglobulins in breast milk

Caroline J Chantry, Kiersten Israel-Ballard, Zina Moldoveanu, Jan Peerson, Anna Coutsoudis, Lindiwe Sibeko, Barbara Abrams

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


BACKGROUND: Heat-treated expressed breast milk is recommended by the World Health Organization as an option to reduce vertical HIV transmission in resource-poor regions. Flash-heat (FH) is a low technology pasteurization method developed for home use, but its effect on quantity and quality of breast milk immunoglobulins is unknown. OBJECTIVE: To evaluate FH's effect on breast milk immunoglobulin levels and antigen-binding capacity. DESIGN/METHODS: Fifty HIV+ mothers in South Africa provided breast milk. Part of each sample served as an unheated control; the remainder was flash-heated. Total and antigen-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) were measured by enzyme-linked immunosorbent assay. Paired t test was performed on log-transformed data. RESULTS: FH significantly decreased total IgA and IgG concentrations [geometric mean (geometric SD) 318.0 (1.9) vs. 398.2 (1.9) μg/mL and 89.1 (2.7) vs. 133.3 (2.5) μg/mL, P < 0.001 each]. Similar decreases in antiĝ€"HIV-1 gp120 IgG, antiĝ€"pneumococcal polysaccharide, and antiĝ€"poliovirus IgA occurred (P < 0.001 each). Although the latter was most affected, FH retained 66% of the antigen-binding ability. In contrast, binding capacity of IgA and IgG to influenza increased after FH (P = 0.029 and 0.025, respectively). CONCLUSIONS: Most breast milk immunoglobulin activity survives FH, suggesting flash-heated breast milk is immunologically superior to breast milk substitutes. Clinical significance of this decreased immunoglobulin activity needs evaluation in prospective trials.

Original languageEnglish (US)
Pages (from-to)264-267
Number of pages4
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number3
StatePublished - Jul 2009


  • Antibody
  • Antibody specificity
  • Breast milk
  • Flash-heat treatment
  • HIV positive
  • IgA
  • IgG
  • Pasteurization

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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