Hygienic and sanitary conditions of hospital milk dispensaries / Condições higiênicos sanitárias de lactários hospitalares

Camilla Alves Pereira Rodrigues, Maria Luiza Rezende Ribeiro, Mário Ernesto Piscoya Diaz, Liana Jayme Borges, Maria Raquel Hidalgo Campos


The aim of this study was to perform a situational and sanitary diagnosis in milk dispensaries of pediatric hospitals in a municipality in central Brazil, with the characterization of the hygienic and sanitary conditions in the location. This investigation happened in two stages, before and after intervention, which consisted of a training about good handling practices for the professionals involved in the formula production process. For microbiological analyses, 640 samples were obtained from milk dispensaries of five hospitals. The microorganisms found indicate flaws in the operational procedures, offering risks to patients. Interventions were an important tool to improve the process. The unsatisfactory hygienic and sanitary conditions, demonstrated in the applied checklist, may offer risks to the quality of Infant Milk Formulas produced in the milk dispensaries studied. In order for the food to be offered safely to interned infants, both inspection from Sanitary Surveillance and specific infant sanitary legislation are necessary


Food handling, Food microbiology, Good manufacturing practices, Infant formula, Training

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World Health Organization (WHO). Indicators for assessing infant and young child feeding practices. Geneva: WHO; 2008.

Redmond EC, Griffith CJ. The importance of hygiene in the domestic kitchen: implications for preparation and storage of food and infant formula. Perspect public health 2009;129: 69–76.

Drudy D, Mullane NR, Quinn T, Wall PG, Fanning S. Enterobacter sakazakii: an emerging pathogen in powdered infant formula. Clin infect dis 2006; 42:996–1002.

Bundesinstitut Fur Risikobewertung (BFR). Recommendations for the hygienic preparation of infant formula in powder form. Berlin: BFR; 2012.

Brasil. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução RDC 12 de 2 de janeiro de 2001 [internet]. [cited 2017 Aug 12]. Available at: http://portal.anvisa.gov.br/wps/wcm/connect/a47bab8047458b909541d 53fbc4c6735 /RDC_12_2001.pdf?MOD=AJPERES.

American Public Health Association (APHA). Compendium of methods for the microbiological examination for foods. Washington: APHA; 2001.

Food and Drug Administration (FDA). Enumeration of Escherichia coli and the coliform bacteria. Silver Spring: FDA; 2002.

American Public Health Association (APHA). Standard methods for the examination of water and wastewater. Washington: APHA; 2005.

Evancho GM, Sveum WH, Moberg LJ, Frank JF. Microbiological monitoring of the food processing environment. In: Downes FP, Ito K. Compendium of methods for the microbiological examination for foods. 4th ed. Washington, D.C.: APHA; 2001. p. 25-36.

Vandenbergh MF, Yzerman EP, Van-Belkum A, Boelens HA, Sijmons M, Verbrugh HA. Follow-up of Staphylococcus aureus nasal carriage after 8 years: redefining the persistent carrier state. J clin microbiol 1999; 37(10):3133-3140.

Brasil. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução RDC 63 de 6 de julho de 2000 [internet]. [cited 2017 Aug 14]. Available at: http://portal.anvisa.gov.br/wps/wcm/connect/61e1d3804745 97399f7bdf3fbc4c6735 /RCD+N%C2%B0+63-2000.pdf?MOD=AJPERES.

Brasil. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução RDC 275 de 21 de outubro de 2002. [internet]. [cited 2017 Aug 14]. Available at: http://portal.anvisa.gov.br/wps/wcm/connect/dcf7a90047 4576fa84cfd43fbc4c6735/RDC+N%C2%BA+275,+DE+21+DE+OUTUBRO+DE+2002.pdf? MOD=AJPERES

Weisstaub G, Uauy R. Non-breast milk feeding in developing countries: challenge from microbial and chemical contaminants. Ann nutr metab 2012; 60:215–219.

Germano PML, Germano MIS. Higiene e vigilância sanitária de alimentos. 4th ed. Barueri: Manole; 2011.

Rossi P, Kabuki DY, Kuaye AY. Microbiological quality in preparing the infant milk formula in hospital milk dispensary. Rev Inst Adolfo Lutz 2010; 69(4):503-509.

Mendes RA, Coelho AIM, Azeredo RMC. Contamination by Bacillus cereus on equipment and utensil surfaces in a food and nutrition service unit. Ciênc saúde coletiva 2011; 16(9):3933-3938.

Koseki S, Nakamura N, Shiina T. Comparison of desiccation tolerance among Listeria monocytogenes, Escherichia coli O157:H7, Salmonella enterica, and Cronobacter sakazakii in powdered infant formula. J Food Prot 2015; 78(1):104-110.

Redmond EC, Griffith CJ, Riley S. Contamination of bottles used for feeding reconstituted powdered infant formula and implications for public health. Perspect public health 2009; 129(21):85-94.

Sánchez-Carrillo C, Padilla B, Marín M, Rivera M, Cercenado E, Vigil D, Sánchez-Luna M, Bouza E. Contaminated feeding bottles: the source of an outbreak of Pseudomonas aeruginosa infections in a neonatal intensive care unit. Am j infect control 2009; 37(2):150-154.

Food and Agriculture Organization of the United Nations (FDA)/ World Health Organization (WHO). Enterobacter sakazakii and other microorganisms in powdered infant formula. Microbiological risk assessment series 2004.

Cairo RC, Silva LS, Andrade CF, Barberino MGA, Bandeira AC, Santos KP, Diniz-Santos DR. Bacterial contamination in milk kitchens in pediatric hospitals in Salvador, Brazil. Braz j infect dis 2008; 12(3):217-221.

Souza MS, Medeiros LB, Saccol ALF. Implementation of good practice in a unit of nutrition in the city of Santa Maria (RS). Braz J Food Nutr 2013; 24(2):203-207.

Gomes NAA, Campos MRH, Monego ET. Sanitary aspects of food preparation in public schools of Goiás, Brazil. Rev nutr 2012; 25(4):473-485.

Akutsu RC, Botelho RA, Camargo EB, Sávio KEO, Araújo WC. Adequacy of good manufacturing procedures in foodservice establishments. Rev nutr 2005; 18(3):419-427.

Agostoni C, Axelsson I, Goulet O, Koletzko B, Michaelsenm KF, Puntis JW, Rigo J, Shamir R, Szajewska H, Turck D, Vandenplas Y, Weaver LT. Preparation and handling of powdered infant formula: acommentary by the ESPGHAN Committee on Nutrition. J pediatr gastroenterol nutr 2004; 39(4):320-322.

Soares LS, Almeida RCC, Cerqueira ES, Carvalho JS, Nunes IL. Knowledge, attitudes and practices in food safety and the presence of coagulase positive staphylococci on hands of food handlers in the schools of Camaçari, Brazil. Food control 2012; 27:206-213.

Farias JKR, Pereira MMS, Figueiredo EL. Evaluation of good practice and counting microbiological of food supply unit for a hospital, the municipality of San Miguel Guam. Aliment nutr 2011; 22(1):113-119.

Piovacari SMF, Figueira VACR, Potenza ALS. Segurança Alimentar: lactário. Einstein: Educ Contin Saúde 2009; 7(4): 216-218.

Trindade AA, Sturion GL, Porto E. Evaluation the level of compliance with good manufacturing practices in hospital lactary. Hig aliment 2009; 23(172/173):48-54.

Kent RM, Fitzgerald GF, Hill C, Stanton C, Ross RP. Novel approaches to improve the intrinsic microbiological safety of powdered infant milk formula. Nutrients 2015; 7:1217-1244.

DOI: https://doi.org/10.34117/bjdv6n5-207


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