Table 4.

Effects of HPP on safety of human milk*.

	Reference	HPP treatment parameters	Device	Studied milk components/properties	Impact of treatment (compared to raw milk)	Comparison HoP – HPP
Pathogens	Kontopodi et al. (24)	Many conditions have been tested: −400 MPa 5, 10, 30 min −500 MPa 1.5, 2 × 1.5, 3, 5 min −600 MPa 1.5, 2 × 1.5, 3, 5 min (n = 2)	Pilot-scale equipment (Resato, Roden, Netherlands).	Inactivation of E. cloacae and S. aureus	>7.8 Log10 reduction (below detection limit) for all HPP-tested parameters	The same inactivation was obtained after HoP for all tested bacterial strains. (>7.8 Log10 reduction; below detection limit).
				Bacteriostatic capacity	NS	NS
	Dussault et al. (42)	4 cycles of 6 min; 425 MPa; 4°C and 37°C (n = 6)	Industrial-scale equipment (Model 135; Hiperbaric, Spain).	Diminution of initial milk bacterial flora	Preincubation of milk to 37°C seem to facilitate bacterial destruction by HPP treatment	No difference was observed in post- pasteurization bacterial loads between HPP and HoP treated milk (p > 0.16).
	Irazusta et al. (43)	Many conditions have been tested at 20°C: −400 MPa 5 min −450 MPa 5 min −500 MPa 5 min (n = 8)	S-IL-100-250-09 W (HP Food Processor, UK).	Microbiological Inactivation: Coliforms Total aerobic bacteria	Decreased bacterial concentration below detection limit Results for raw milk were not presented	NS (Median total counts obtained for HPP-treated samples at 400, 450, and 500 MPa were equal to median counts obtained for the HoP-treated samples)
	Pitino et al. (44)	500 MPa; 8 min T° not mentionned (n = 17)	Industrial-scale equipment (Model 135; Hiperbaric, Spain).	Diminution of initial milk bacterial flora	All methods of pasteurization increased the number of culture negative milk samples (<1 × 103 CFU/L) compared with pre pasteurization p (<0.05).	Higher proportion of samples with negative cultures after HPP than after Holder but NS (p = 0.06)
B. cereus	Jarzynka et al. (45)	450 MPa; 15 min; 21°C (n = 6)	Pilot-scale equipment (U 4000/65, Unipress Equipment, Poland).	Microbiological Inactivation: E. coli (1.2 × 107 CFU/mL) L. monocytogenes (8.2 × 107 CFU/mL) S. aureus (6.9 × 106 CFU/mL) C. sakazakii (8 × 105 CFU/mL) Sporulating B. cereus (4 × 105 CFU/mL)	Complete inactivation	Total vegetative forms of the native microbiota were destroyed by HoP; no result for sporulating forms after HoP
Microbicidal activity	Barbarska et al. (46)	Many conditions have been tested: −450 MPa; 15 min −200 MPa; 10 min + 400 MPa; 10 min Inoculation of 6 × 107 CFU/mL of E coli, post-HPP treatment; incubation for 2 h at 37°C. (n = 6)	Pilot-scale equipment (U 4000/65, Unipress Equipment, Poland).	Bactericidal activity against E. coli	NS (reduction of E. coli growth from 29.6 to 50.3%)	Not compared
	Kothari et al. (47)	1 cycle of 8 min; 500 MPa, 4°C Following HPP treatment, milk was spiked with CMV (~5 log PFU/mL) and incubated up to 4 h at room temperature. Post-incubation CMV titers were measured.(n = 10)	Industrial-scale equipment (Model 135; Hiperbaric, Spain).	Anti-cytomegalovirus activity	HPP-treated milk maintains anti-CMV activity comparable to raw milk. After a 30-min incubation period, 3.4 and 3.7 log PFU/mL were measured in raw and HPP-treated milk, respectively.	HoP-treated milk maintains anti-CMV activity comparable to HPP-treated milk after a 30-min post- pasteurization period. Not significantly different.
Viruses	Pitino et al. (48)	Many conditions have been tested at <10°C: −350 MPa 8 and 10 min −500 MPa 8 and 10 min −600 MPa 8 and 10 min	1 L-pilot unit Dustec Hochdrunktechnik GmbH (Germany).	Cytomegalovirus (CMV) Hepatitis A virus (HAV)	Reduction of CMV (initial load: 5.1 log PFU/mL) and HAV (initial load: 5.7 log PFU/mL) below the detection limit for all HPP treatments;	NS for reduction of CMV HoP was less effective than HPP treatments in reducing HAV in human milk (p < 0.05).

*p-value are indicated only when significant and/or reported in the original article; NS, not significantly different.