Can high hydrostatic pressure processing be the best way to preserve human milk?

Background: Breastfeeding is one of the most important factors influencing proper child development. When a mother cannot breastfeed, the best alternative, especially for feeding premature infants, is to then use of human milk (HM) which has been collected, preserved and stored in Human Milk Banks (HMB). Scope and approach: In this review, the impact of some stages of the management of HM in HMB on its final biological value and microbiological safety are described. Negative changes in HM components begin during the first stage of frozen storage. In the next stages, further losses occur, which largely depend on the applied method of microbiota elimination. Complete inactivation of milk microbiota can be achieved after pressurization in the range 500-600 MPa, but similarly for holder pasteurization (HoP), in these conditions unfavorable changes in the milk components take place. M lower pressures, the changes are smaller, but microbiological safety of HM is not achieved. Key findings and conclusions: Replacing HoP with pressurization does not seem to be justified so far, not only because of the small differences in the retention of valuable HM ingredients, but also because of the high costs associated with the inclusion of the device for generating pressure in the HMB environment. A new solution may be the use of high-pressure milk storage at subzero temperatures, but this hypothesis must be verified.