Flash heating explanation

Flash heating explanation
  • Always wash all utensils that you will use to express and heat treat your breastmilk with clean water and soap. It is best to boil these utensils after washing to make sure that they are clean.
  • Put all the milk in a heat-resistant glass (not plastic) jar. The amount of milk should be between 50 ml and 150 ml. If you have more milk, you may divide it into 2 jars.
  • Place the jar of milk in a small pan of water. Make sure the water is about two fingers above the level of milk so that all the milk will be heated well.1
  • Heat the water on a very hot fire or on the highest level of your stove until it reaches a rolling boil (when the water has large bubbles). Stay close by because this should only take a few minutes. Leaving the water to boil too long will damage some of the nutrients in the milk.2
  • Remove the jar of milk from the boiling water immediately after the water comes to a boil. Place the jar in a container of cool water, or let it stand alone to cool until it reaches room temperature.
  • Protect the milk as it cools and during storage by placing a clean lid or small plate on it.
  • You can safely feed your baby this heated milk within 6 hours.
  • You can feed the baby using a clean open cup. Even a newborn baby learns quickly how to drink from a cup. Avoid using bottles and nipples. They are difficult to clean and may make your baby sick.

Below is Kiersten Israel-Ballard demonstrating flash-heating on the stovetop.

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Flash heat and HIV
Given the specific risks for lactating parents in developing country settings, research studies focused on determining the impact of flash-heat on HIV, bacteria, and breastmilk’s protective elements, such as immunoglobulins, vitamins, and the immunoreactive proteins lactoferrin and lysozyme.

Studies3 by a research team led by Israel-Ballard,4 5 6 have shown that FH breastmilk inactivates HIV and 4 common bacteria7 while retaining high levels of vitamins,8 lactoferrin,9 and immunoglobulin,10 which are important for the health of a baby and its immunity to infections. See Why breastmilk for more information on the importance of the anti-infective components of breastmilk.

Safety of flash-heating
When researchers designed the flash-heat method for lactating parents in developing countries, it was an attempt to replicate the flash-pasteurization methodology for a low-resource setting. Flash-heating is a simplified in-home process and as such is not as controlled as the actual flash pasteurization method. Altitude, breastmilk volumes, water volumes, and human error could contribute to differences in the flash-heat process. Although researchers hypothesize that the temperatures achieved during flash-heat render breastmilk safe, it should be noted that its effectiveness to inactive all viruses and spores11 has not been thoroughly researched and remains theoretical.

When heat-treating human milk, many important anti-infective properties are reduced. The Holder method affects these properties in a greater way than Flash heating. Any heat treatment deactivates lipase, an enzyme that helps with the breakdown and absorption of fats, and the long-term effects of feeding heat-treated milk have not been researched12 Raw (unpasteurized), fresh (not frozen when possible) human milk, from a properly screened donor, and properly handled is a better option when available.

Next: Flash-heating versus Flash-pasteurizing

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  1. For more information on cup feeding, please see How do I feed the milk to my baby? ↩︎
  2. Source Unknown – How can you safely heat treat breastmilk ↩︎
  3. UCBerkelyNews – HIV in breastmilk killed by flash-heating ↩︎
  4. Mduduzi N. N. Mbuya, et al. 2010. Heat Treatment of Expressed Breast Milk Is a Feasible Option for Feeding HIV-Exposed, Uninfected Children after 6 Months of Age in Rural Zimbabwe ↩︎
  5. Kiersten Israel-Ballard, MPH, et al. 2007. Flash-Heat Inactivation of HIV-1 in Human Milk ↩︎
  6. Letter to the Editor. Mylene L. Volk, MS, Carl V. Hanson, PhD, Kiersten Israel-Ballard, PhD, Caroline J. Chantry, MD. J Acquir Immune Defic Syndr. Volume 53, Number 5, April 15, 2010. Inactivation of Cell-Associated and Cell-Free HIV-1 by Flash-Heat Treatment of Breast Milk ↩︎
  7. K. Israel-Ballard, et al. 2006. Bacterial Safety of Flash-heated and Unheated Expressed Breastmilk during Storage ↩︎
  8. Kiersten Israel-Ballard, et al. 2008. Vitamin Content of Breast Milk From HIV-1–Infected Mothers Before and After Flash-Heat Treatment ↩︎
  9. Kiersten Israel-Ballard, MPH, et al. 2007. Flash-Heat Inactivation of HIV-1 in Human Milk ↩︎
  10. Caroline J. Chantry, et al. 2009. Effect of Flash-heat Treatment on Immunoglobulins in Breastmilk. ↩︎
  11. Please see Bacteria for more information. ↩︎
  12. Please also see ‘What about premature babies? ↩︎