Maximising the clinical use of donor human milk

Abstract

Donor human milk (DHM) is the preferred alternative when a mother’s own milk (MOM) is unavailable, as it provides essential nutrients for infant growth and development. However, its use particularly in low-resource settings, is constrained by logistical challenges in preservation, storage, transport, and purity assurance within human milk banks (HMB). This research addresses these limitations to enhance DHM accessibility and clinical potential. The first objective investigated the impact of freeze-drying on the compositional stability of DHM stored at varying temperatures for up to 24 months. Results demonstrated that freeze-dried DHM retained its nutrient profile, especially at ambient temperatures, eliminating the need for cold-chain storage and simplifying supply logistics. Building on this, the second objective assessed the ANUE packaging system’s ability to endure the freeze-drying process. The ANUE pouch maintained structural integrity, preserved nutrient content, and introduced no microbial contamination, presenting a feasible solution for safe, long-term DHM storage. The third objective explored a novel therapeutic application of DHM by evaluating its effect on Clostridioides difficile growth. In vitro experiments showed that bioactive components in pasteurised and unpasteurised DHM inhibited C. difficile, suggesting potential for DHM as an adjunct or alternative to antibiotics or faecal microbiota transplant (FMT) in treating infection. The final objective addressed DHM quality control. Rapid mass spectrometry techniques: MALDI-TOF MS, RADIAN-ASAP, and LA-REIMS, were used to detect adulteration with cow’s milk, formula, or water. Among these, LA-REIMS emerged as the fastest and most accurate, offering robust quality assurance. Together, these findings support broader, safer, and more sustainable clinical and emergency use of DHM. By improving long-term storage, enabling new therapeutic avenues, and enhancing quality monitoring, this research contributes to expanding the global impact of donor milk.

Thesis embargoed until 31st July 2030.

Date of Award	Jul 2025
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Marie Sklodowska Curie COFUND
Supervisor	Simon Cameron (Supervisor) & Bernard Collins (Supervisor)