Gestión de la calidad en los Bancos de Leche Humana: revisión de alcance

Fogliano, Rosana Rodrigues Figueira; Bohomol, Elena; Schveitzer, Mariana Cabral; Coca, Kelly Pereira; Abrão, Ana Cristina Freitas de Vilhena

Rosana Rodrigues Figueira Fogliano

Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

http://orcid.org/0000-0003-4129-4933

Elena Bohomol

Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

http://orcid.org/0000-0002-7196-0266

Mariana Cabral Schveitzer

Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

http://orcid.org/0000-0001-9833-2932

Kelly Pereira Coca

Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

http://orcid.org/0000-0002-3604-852X

Ana Cristina Freitas de Vilhena Abrão

Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

http://orcid.org/0000-0001-6249-2467

Corresponding author: Rosana Rodrigues Figueira Fogliano Email: rosana.fogliano@unifesp.

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Ana Fátima Fernandes

Authors	Title	Country	Journal	Year
Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB⁽¹⁴14 Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB. Innovative techniques of processing human milk to preserve key components. nutrients. 2019;11(5). doi: 10.3390/nu11051169 https://doi.org/10.3390/nu11051169... ⁾	Innovative Techniques of Processing Human Milk to Preserve Key Components	Poland	Nutrients	2019
Hartmann BT⁽¹⁵15 Hartmann BT. Ensuring safety in donor milk banking in neonatal intensive care. Clin Perinatol. 2017;44(1):131-49. doi: 10.1016/j.clp.2016.11.006 https://doi.org/10.1016/j.clp.2016.11.00... ⁾	Ensuring Safety in Donor Human Milk Banking in Neonatal Intensive Care	Australia	Clinics in Perinatology	2017
Peila C, Emmerik NE, Giribaldi M, et al.⁽¹⁶16 Peila C, Emmerik NE, Giribaldi M, et al. Human milk processing: a systematic review of innovative techniques to the ensure safety and quality of donor milk. J Pediatr Gastroenterol Nutr. 2016;64(3):353-61. doi: 10.1097/mpg.0000000000001435 https://doi.org/10.1097/mpg.000000000000... ⁾	Human Milk Processing: A Systematic Review of Innovative Techniques to Ensure the Safety and Quality of Donor Milk	Italy	Journal of Pediatric Gastroenterology & Nutrition	2017
Grazziotin et al.⁽¹⁷17 Grazziotin MCB, Grazziotin AL, Vidal NM, Freira MHS, Silva RPGVC. Analysis of the storage methods for raw human milk from mothers with infants admitted to a neonatal intensive care unit, according to Brazilian Regulations, J Hum Lact. 2016;32(3):446-54. doi: 10.1177/0890334416647710 https://doi.org/10.1177/0890334416647710... ⁾	Analysis of the Storage Methods for Raw Human Milk from Mothers with Infants Admitted to a Neonatal Intensive Care Unit, According to Brazilian Regulations	Brazil	Journal of Human Lactation	2016
Naicker M, Coutsoudis A, Israel-Ballard K, Chaudhri R, Perin N, Mlisana K.⁽¹⁸18 Naicker M, Coutsoudis A, Israel-Ballard K, Chaudhri R, Perin N, Mlisana K. Demonstrating the efficacy of the foneastra pasteurization monitor for human milk pasteurization in resource-limited settings. Breastfeed Med. 2015;10(2):107-12. doi: 10.1089/bfm.2014.0125 https://doi.org/10.1089/bfm.2014.0125... ⁾	Demonstrating the efficacy of the FoneAstra pasteurization monitor for human milk pasteurization in resourcelimited settings	South Africa	Breastfeeding Medicine	2015
De Nisi G, Moro GE, Arslanoglu S, Ambruzzi AM, Biasini A, Profeti C, et al.⁽¹⁹19 Nisi G, Moro GE, Arslanoglu S, Ambruzzi AM, Biasini A, Profeti C, et al. Survey of Italian human milk banks. J Hum Lact. 2015;31(2):294-300. doi: 10.1177/0890334415573502 https://doi.org/10.1177/0890334415573502... ⁾	Survey of Italian human milk banks	Italy	Journal of Human Lactation	2015
ME Maes, MT Possamai, MG Assoler, FAH Sardá⁽²⁰20 Maes ME, Possamai MT, Assoler MG, Sardá FAH. Sistema APPCC em banco de leite humano, Hig Alim [Internet]. 2015 [2017 Marc 03];29:248-9. Available from: https://www.academia.edu/19465644/SISTEMA_APPCC_EM_BANCO_DE_LEITE_HUMANO https://www.academia.edu/19465644/SISTEM... ⁾	Sistema HACCP em banco de leite humano	Brazil	Higiene Alimentar	2015
Menezes G, de Lima-Cavalcanti L, de Morais-Oliveira AM, Costa-Pinto Rde M, Steffen-Abdallah VO⁽²¹21 Menezes G, Lima-Cavalcanti L, Morais-Oliveira AM, Costa-Pinto RM, Steffen-Abdallah VO. Evaluation of home collection performed by a human milk bank in a university hospital in Brazil. Salud Publica Mex [Internet]. 2014 [2017 Marc 03];56(3):245-50. Available from: https://www.researchgate.net/publication/266381549_Evaluation_of_home_collection_performed_by_a_human_milk_bank_in_a_university_hospital_in_Brazil https://www.researchgate.net/publication... ⁾	Evaluation of home collection performed by a human milk bank in a university hospital in Brazil	Brazil	Salud Publica de Mexico	2014
Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA⁽²²22 Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA. Donor human milk bank data collection in North America: an assessment of current status and future needs. J Hum Lact. 2014;30(1):47-53. doi: 10.1177/0890334413508237 https://doi.org/10.1177/0890334413508237... ⁾	Donor human milk bank data collection in north America: an assessment of current status and future needs	United States	Journal of Human Lactation	2014
Spatz, D. L., Schmidt, K. J. & Kinzler, S⁽²³23 Spatz DL, Schmidt KJ, Kinzler S. Implementation of a human milk management center. Adv Neonatal Care. 2014;14(4):253-61. doi: 10.1097/ANC.0000000000000084 https://doi.org/10.1097/ANC.000000000000... ⁾	Implementation of a human milk management center	United States	Advances in Neonatal Care	2014
Carroll, K⁽²⁴24 Carroll K. Body dirt or liquid gold? how the “safety” of donated breast milk is constructed for use in neonatal intensive care. Soc Stud Sci. 2013;44(3)466-85. doi: 10.1177/0306312714521705 https://doi.org/10.1177/0306312714521705... ⁾	Body dirt or liquid gold? How the 'safety' of donated breastmilk is constructed for use in neonatal intensive care	United States	Social Studies of Science	2014
Vieczorek, A., Wolff, L.⁽²⁵25 Vieczorek A, Wolff L. Evaluation of human milk banks in Paraná - Br: a comparative study. O Braz J Nurs. 2012;11(1). doi: 10.5935/1676-4285.20120009 https://doi.org/10.5935/1676-4285.201200... ⁾	Evaluation of Human Milk Banks in Paraná - Br: a comparative study	Brazil	Online Brazilian Journal of Nursing	2012
Torrezan AC⁽²⁶26 Torrezan AC. Gestão do processo assistencial e de processamento de Banco de Leite Humano com foco na melhoria da qualidade [Dissertação]. Instituição de Ensino: Universidade Federal de São Carlos, São Carlos; 2010[2017 Jun 07]. Available from: https://repositorio.ufscar.br/handle/ufscar/3224?show=full https://repositorio.ufscar.br/handle/ufs... ⁾	Gestão do processo assistencial e processos de Banco de leite	Brazil	Online Master's Dissertation	2011
Grazziotin AL, Grazziotin MCB, Letti LAJ⁽²⁷27 Grazziotin AL, Grazziotin MCB, Letti LAJ. Disposal of human milk donated to a human milk bank before and after measures to reduce the amount of milk unsuitable for consumption. J Pediatr. 2010;86(4):290-4. doi: 10.2223/JPED.2014 https://doi.org/10.2223/JPED.2014... ⁾	Disposal of human milk donated to a human milk bank before and after measures to reduce the amount of milk unsuitable for consumption	Brazil	Jornal de pediatria	2010
Silva JHF⁽²⁸28 Silva JHF. Inovações tecnológicas para uma estratégia de qualificação dos produtos e dos processos de trabalho em Bancos de Leite Humano: o sistema de gerenciamento BLHWEB. [Dissertação] [Internet]. Escola Nacional de Saúde Pública Sergio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro; 2009 [2017 Jun 07]; Available from: https://www.arca.fiocruz.br/handle/icict/2442 https://www.arca.fiocruz.br/handle/icict... ⁾	Inovações tecnológicas para uma estratégia de qualificação dos produtos e dos processos de trabalho em Bancos de Leite Humano: o sistema de gerenciamento BLMWEB	Brazil	Master's Dissertation	2009
Silva ER, Abdallah VOS, Oliveira AMM⁽²⁹29 Silva ER, Abdallah VOS, Oliveira AMM. Qualidade microbiológica do leite humano ordenhado no domicílio: eficácia de uma ação educativa. In 5ª Semana Acadêmica Universidade Federal de Uberlândia, [Internet]. 2008 [2017 Jun 01]. Available from https://ssl4799.websiteseguro.com/swge5/seg/cd2008/pdf/sa08-21093.pdf https://ssl4799.websiteseguro.com/swge5/... ⁾	Qualidade microbiológica do leite humano ordenhado no domicílio: eficácia de uma educational action	Brazil	5^th Academic Week.Universidade Federal de Uberlândia	2008
Costa ACM, Pereira DCA, Silva JAR, Neto JPS, Britto MHSS⁽³⁰30 Costa ACM, Pereira DCA, Silva JAR, Silva Neto JP, Britto MHSS. Avaliação da qualidade dos bancos de leite humano no município de São Luis-Ma, no período de abril a junho de 2003. Rev Hosp Univ UFMA [Internet]. 2003 [2017 Jun 01];38. http://www2.ebserh.gov.br/documents/16424/491465/Revista_HU_Volume_4_3_SET_DEZ_2003.pdf/181a1c18-30e3-4518-9da3-e7359649fced http://www2.ebserh.gov.br/documents/1642... ⁾	Avaliação da qualidade dos bancos de leite humano no município de São Luís- MA, no período de abril a junho de 2003	Brazil	UFMA University Hospital Journal	2003

Authors	Objectives	Improvement interventions	Outcomes
Wesolowska et al., 2019⁽¹⁴14 Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB. Innovative techniques of processing human milk to preserve key components. nutrients. 2019;11(5). doi: 10.3390/nu11051169 https://doi.org/10.3390/nu11051169... ⁾	To compare HM pasteurization methods to improve the safety and quality of donated milk.	Critical analysis	HPP and ultraviolet-C irradiation methods seem to minimize losses as a result of HM processing.
Hartmann, 2017⁽¹⁵15 Hartmann BT. Ensuring safety in donor milk banking in neonatal intensive care. Clin Perinatol. 2017;44(1):131-49. doi: 10.1016/j.clp.2016.11.006 https://doi.org/10.1016/j.clp.2016.11.00... ⁾	To assess the risks and benefits for HMB donors and recipients using a systematic method.	Risk management - HACCP	Potential hazards and benefits are identified at each stage of HMB processes, and the minimum acceptable standard for safe practice is defined.
Peila et al., 2017⁽¹⁶16 Peila C, Emmerik NE, Giribaldi M, et al. Human milk processing: a systematic review of innovative techniques to the ensure safety and quality of donor milk. J Pediatr Gastroenterol Nutr. 2016;64(3):353-61. doi: 10.1097/mpg.0000000000001435 https://doi.org/10.1097/mpg.000000000000... ⁾	To assess the evidence on the effectiveness of new pasteurization techniques on the quality and safety of HM	Critical analysis	The HTST method showed equivalence to the standard pasteurization method, guaranteeing the microbiological safety of HM.
Grazziotin et al., 2016⁽¹⁷17 Grazziotin MCB, Grazziotin AL, Vidal NM, Freira MHS, Silva RPGVC. Analysis of the storage methods for raw human milk from mothers with infants admitted to a neonatal intensive care unit, according to Brazilian Regulations, J Hum Lact. 2016;32(3):446-54. doi: 10.1177/0890334416647710 https://doi.org/10.1177/0890334416647710... ⁾	To assess the evidence on the raw HM storage protocol according to Brazilian regulations.	Critical analysis	The methods of storage in refrigeration (5°C/12 hours) and freezing (20°C/15 days) were validated and the energy content of milk was preserved.
Naicker et al., 2015⁽¹⁸18 Naicker M, Coutsoudis A, Israel-Ballard K, Chaudhri R, Perin N, Mlisana K. Demonstrating the efficacy of the foneastra pasteurization monitor for human milk pasteurization in resource-limited settings. Breastfeed Med. 2015;10(2):107-12. doi: 10.1089/bfm.2014.0125 https://doi.org/10.1089/bfm.2014.0125... ⁾	To assess the safety and effectiveness of a mobile pasteurization monitor, FoneAstra, based on Smartphone, as a quality control system for the pasteurization process.	Information technology	None of the samples pasteurized using FoneAstra showed bacterial growth. The innovative tool proved to be safe, effective and low cost for HM pasteurization.
De Nisi et al., 2015⁽¹⁹19 Nisi G, Moro GE, Arslanoglu S, Ambruzzi AM, Biasini A, Profeti C, et al. Survey of Italian human milk banks. J Hum Lact. 2015;31(2):294-300. doi: 10.1177/0890334415573502 https://doi.org/10.1177/0890334415573502... ⁾	To compare the operating procedures of 28 Italian HMB to identify areas of strength and improvement.	Benchmarking	Divergence in the structure (number of hours worked, number of rooms and number of equipment), in the selection processes and mandatory microbiological control.
ME Maes et al., 2015⁽²⁰20 Maes ME, Possamai MT, Assoler MG, Sardá FAH. Sistema APPCC em banco de leite humano, Hig Alim [Internet]. 2015 [2017 Marc 03];29:248-9. Available from: https://www.academia.edu/19465644/SISTEMA_APPCC_EM_BANCO_DE_LEITE_HUMANO https://www.academia.edu/19465644/SISTEM... ⁾	To manage risk and control food safety hazards at HMB.	Risk management - HACCP	The critical points were identified: 6 prevented (CCPp), 4 eliminated (CCPe) and 1 reduced (CCPr), which made corrective actions possible.
Menezes et al., 2014⁽²¹21 Menezes G, Lima-Cavalcanti L, Morais-Oliveira AM, Costa-Pinto RM, Steffen-Abdallah VO. Evaluation of home collection performed by a human milk bank in a university hospital in Brazil. Salud Publica Mex [Internet]. 2014 [2017 Marc 03];56(3):245-50. Available from: https://www.researchgate.net/publication/266381549_Evaluation_of_home_collection_performed_by_a_human_milk_bank_in_a_university_hospital_in_Brazil https://www.researchgate.net/publication... ⁾	To assess home collection and transport of raw HM during home visits.	Checklist	Weaknesses in the collection process were identified, such as hair protection (93.8%), hand hygiene (83.3%), nail care (87.5%) and neglecting the first drops (33.3%).
Brownell et al., 2014⁽²²22 Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA. Donor human milk bank data collection in North America: an assessment of current status and future needs. J Hum Lact. 2014;30(1):47-53. doi: 10.1177/0890334413508237 https://doi.org/10.1177/0890334413508237... ⁾	To monitor data from HMBANA belonging to HMBANA, on the characteristics of the donor and donated milk, the feasibility and the interest in participating in a central registry.	Information technology	There was no uniformity in the data collected. A lack of standardization and transparency of information was identified.
Spatz et al., 2014⁽²³23 Spatz DL, Schmidt KJ, Kinzler S. Implementation of a human milk management center. Adv Neonatal Care. 2014;14(4):253-61. doi: 10.1097/ANC.0000000000000084 https://doi.org/10.1097/ANC.000000000000... ⁾	To analyze the key activities in the implementation of an HM management center in a children's hospital.	Flow mapping	Structural weaknesses, the need to improve processes, change in local culture, training of teams and periodic assessment of results were identified.
Carroll, 2014⁽²⁴24 Carroll K. Body dirt or liquid gold? how the “safety” of donated breast milk is constructed for use in neonatal intensive care. Soc Stud Sci. 2013;44(3)466-85. doi: 10.1177/0306312714521705 https://doi.org/10.1177/0306312714521705... ⁾	To draw the flow of the donated HM of two HMB, from selection to distribution and assess the the process safety.	Flow mapping	The variety of practices and security process in the selection and education of donors, pasteurization and microbiological analysis of the HM between the two HMB were identified.
Vieczorek & Wolff, 2012⁽²⁵25 Vieczorek A, Wolff L. Evaluation of human milk banks in Paraná - Br: a comparative study. O Braz J Nurs. 2012;11(1). doi: 10.5935/1676-4285.20120009 https://doi.org/10.5935/1676-4285.201200... ⁾	To compare the structure and processes of 8 HMB paranaense based on RDC 171/2006 and ANVISA's HMB operating manual.	Benchmarking	The weak and strong points in the eight HMB were identified. The percentage of compliance ranged from 72 to 85% and non-compliance showed an average of 21%.
Torrezan, 2011⁽²⁶26 Torrezan AC. Gestão do processo assistencial e de processamento de Banco de Leite Humano com foco na melhoria da qualidade [Dissertação]. Instituição de Ensino: Universidade Federal de São Carlos, São Carlos; 2010[2017 Jun 07]. Available from: https://repositorio.ufscar.br/handle/ufscar/3224?show=full https://repositorio.ufscar.br/handle/ufs... ⁾	To implement the Process Management methodology in HM assistance and processing activities.	Flow mapping PDCA Benchmarking	All stages were known and an action plan to improve and monitor all processes was implemented.
Grazziotin et al., 2010⁽²⁷27 Grazziotin AL, Grazziotin MCB, Letti LAJ. Disposal of human milk donated to a human milk bank before and after measures to reduce the amount of milk unsuitable for consumption. J Pediatr. 2010;86(4):290-4. doi: 10.2223/JPED.2014 https://doi.org/10.2223/JPED.2014... ⁾	To assess the causes of disposal of the donated HM and the impact of the implemented measures.	Checklist	The causes of disposal were identified and showed a positive impact in reducing the volume of discarded donated milk.
Silva, 2009⁽²⁸28 Silva JHF. Inovações tecnológicas para uma estratégia de qualificação dos produtos e dos processos de trabalho em Bancos de Leite Humano: o sistema de gerenciamento BLHWEB. [Dissertação] [Internet]. Escola Nacional de Saúde Pública Sergio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro; 2009 [2017 Jun 07]; Available from: https://www.arca.fiocruz.br/handle/icict/2442 https://www.arca.fiocruz.br/handle/icict... ⁾	To know the technological innovations produced by the HMBWEB system in the qualification of HMB performance.	Information system	Construction of indicators that qualify HMB management, processes and procedures.
Silva et al., 2008⁽²⁹29 Silva ER, Abdallah VOS, Oliveira AMM. Qualidade microbiológica do leite humano ordenhado no domicílio: eficácia de uma ação educativa. In 5ª Semana Acadêmica Universidade Federal de Uberlândia, [Internet]. 2008 [2017 Jun 01]. Available from https://ssl4799.websiteseguro.com/swge5/seg/cd2008/pdf/sa08-21093.pdf https://ssl4799.websiteseguro.com/swge5/... ⁾	To compare the physical-chemical and microbiological quality of raw HM at home and at HMB before and after a new educational action.	Educational action	There was no improvement in relation to Dornic acidity and microbiological analysis after educational actions.
Costa et al., 2003⁽³⁰30 Costa ACM, Pereira DCA, Silva JAR, Silva Neto JP, Britto MHSS. Avaliação da qualidade dos bancos de leite humano no município de São Luis-Ma, no período de abril a junho de 2003. Rev Hosp Univ UFMA [Internet]. 2003 [2017 Jun 01];38. http://www2.ebserh.gov.br/documents/16424/491465/Revista_HU_Volume_4_3_SET_DEZ_2003.pdf/181a1c18-30e3-4518-9da3-e7359649fced http://www2.ebserh.gov.br/documents/1642... ⁾	To compare the structure, processes and results of two HMB in the city of São Luís, state of Maranhão.	Benchmarking	Divergences were identified regarding the physical, organizational and process control structures that compromise the quality of the product.

Tools/ Interventions	HMB process	Improvements achieved
Checklist⁽²¹21 Menezes G, Lima-Cavalcanti L, Morais-Oliveira AM, Costa-Pinto RM, Steffen-Abdallah VO. Evaluation of home collection performed by a human milk bank in a university hospital in Brazil. Salud Publica Mex [Internet]. 2014 [2017 Marc 03];56(3):245-50. Available from: https://www.researchgate.net/publication/266381549_Evaluation_of_home_collection_performed_by_a_human_milk_bank_in_a_university_hospital_in_Brazil https://www.researchgate.net/publication... ^,²⁷27 Grazziotin AL, Grazziotin MCB, Letti LAJ. Disposal of human milk donated to a human milk bank before and after measures to reduce the amount of milk unsuitable for consumption. J Pediatr. 2010;86(4):290-4. doi: 10.2223/JPED.2014 https://doi.org/10.2223/JPED.2014... ⁾	Raw HM collection and transport	Improvement of processes
	Raw HM selection	Improvement of processes
Educational action⁽²⁹29 Silva ER, Abdallah VOS, Oliveira AMM. Qualidade microbiológica do leite humano ordenhado no domicílio: eficácia de uma ação educativa. In 5ª Semana Acadêmica Universidade Federal de Uberlândia, [Internet]. 2008 [2017 Jun 01]. Available from https://ssl4799.websiteseguro.com/swge5/seg/cd2008/pdf/sa08-21093.pdf https://ssl4799.websiteseguro.com/swge5/... ⁾	HM collection	Improvement of processes
Critical analysis⁽¹⁴14 Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB. Innovative techniques of processing human milk to preserve key components. nutrients. 2019;11(5). doi: 10.3390/nu11051169 https://doi.org/10.3390/nu11051169... ^,¹⁶16 Peila C, Emmerik NE, Giribaldi M, et al. Human milk processing: a systematic review of innovative techniques to the ensure safety and quality of donor milk. J Pediatr Gastroenterol Nutr. 2016;64(3):353-61. doi: 10.1097/mpg.0000000000001435 https://doi.org/10.1097/mpg.000000000000... ^-¹⁷17 Grazziotin MCB, Grazziotin AL, Vidal NM, Freira MHS, Silva RPGVC. Analysis of the storage methods for raw human milk from mothers with infants admitted to a neonatal intensive care unit, according to Brazilian Regulations, J Hum Lact. 2016;32(3):446-54. doi: 10.1177/0890334416647710 https://doi.org/10.1177/0890334416647710... ⁾	Raw HM storage	Improvement of processes
	Pasteurization	Improvement of processes
Information technology⁽¹⁸18 Naicker M, Coutsoudis A, Israel-Ballard K, Chaudhri R, Perin N, Mlisana K. Demonstrating the efficacy of the foneastra pasteurization monitor for human milk pasteurization in resource-limited settings. Breastfeed Med. 2015;10(2):107-12. doi: 10.1089/bfm.2014.0125 https://doi.org/10.1089/bfm.2014.0125... ^,²²22 Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA. Donor human milk bank data collection in North America: an assessment of current status and future needs. J Hum Lact. 2014;30(1):47-53. doi: 10.1177/0890334413508237 https://doi.org/10.1177/0890334413508237... ^,²⁸28 Silva JHF. Inovações tecnológicas para uma estratégia de qualificação dos produtos e dos processos de trabalho em Bancos de Leite Humano: o sistema de gerenciamento BLHWEB. [Dissertação] [Internet]. Escola Nacional de Saúde Pública Sergio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro; 2009 [2017 Jun 07]; Available from: https://www.arca.fiocruz.br/handle/icict/2442 https://www.arca.fiocruz.br/handle/icict... ⁾	Pasteurization	Continuous monitoring of results
	All processes	Continuous monitoring of results
Flow mapping⁽²³23 Spatz DL, Schmidt KJ, Kinzler S. Implementation of a human milk management center. Adv Neonatal Care. 2014;14(4):253-61. doi: 10.1097/ANC.0000000000000084 https://doi.org/10.1097/ANC.000000000000... ^-²⁴24 Carroll K. Body dirt or liquid gold? how the “safety” of donated breast milk is constructed for use in neonatal intensive care. Soc Stud Sci. 2013;44(3)466-85. doi: 10.1177/0306312714521705 https://doi.org/10.1177/0306312714521705... ^,²⁶26 Torrezan AC. Gestão do processo assistencial e de processamento de Banco de Leite Humano com foco na melhoria da qualidade [Dissertação]. Instituição de Ensino: Universidade Federal de São Carlos, São Carlos; 2010[2017 Jun 07]. Available from: https://repositorio.ufscar.br/handle/ufscar/3224?show=full https://repositorio.ufscar.br/handle/ufs... ⁾	All processes	Continuous monitoring of results
HACCP⁽¹⁵15 Hartmann BT. Ensuring safety in donor milk banking in neonatal intensive care. Clin Perinatol. 2017;44(1):131-49. doi: 10.1016/j.clp.2016.11.006 https://doi.org/10.1016/j.clp.2016.11.00... ^,²⁰20 Maes ME, Possamai MT, Assoler MG, Sardá FAH. Sistema APPCC em banco de leite humano, Hig Alim [Internet]. 2015 [2017 Marc 03];29:248-9. Available from: https://www.academia.edu/19465644/SISTEMA_APPCC_EM_BANCO_DE_LEITE_HUMANO https://www.academia.edu/19465644/SISTEM... ⁾	All processes	Prevent errors and failures

[1] Corresponding author: Rosana Rodrigues Figueira Fogliano Email: rosana.fogliano@unifesp.

Brasil

Brasil

Gestión de la calidad en los Bancos de Leche Humana: revisión de alcance

RESUMEN

Objetivos:

Métodos:

Resultados:

Consideraciones finales: