Susceptibility of riboflavin and vitamin A in breast milk to photodegradation and its implications for the use of banked breast milk in infant feeding.

Up to 50% of the riboflavin and up to 70% of the vitamin A in human drip breast milk samples were destroyed during controlled exposure to daylight, either in translucent polythene bottles, or where the milk was pumped through naso-gastric tubing from a syringe to mimic the conditions of enteral feeding. Losses were also observed in milk which was exposed to standard phototherapy illumination under conditions similar to those encountered in the ward, and in this case riboflavin was destroyed to a greater extent than vitamin A. Photodegradation of riboflavin may contribute to the high incidence of biochemical riboflavin deficiency reported in preterm infants receiving breast milk without vitamin supplements. The implications of these findings for feeding high risk term and preterm infants on donor milk are discussed, and the use of low actinic vessels and tubing to minimise photodegradation is recommended.