Table 3 Effect of treatment methods on CMV infectivity of breastmilk.

Freezing

Welsh et al. [18], Dworsky et al. [19], Hamprecht et al. [4], Hosseini et al. [16], Sam et al. [17]

Mean viral infectivity was reduced by 90% in some studies but increased by 10% in others

Evidence regarding efficacy of freezing is conflicting. Freezing is ineffective in reducing viral loads to non-transmissible levels.

Holder Pasteurization (HoP)

Gaya et al. [32], Hamprecht et al. [4], Dworsky et al. [19]

Viral Infectivity reduction = 100% in all studies

Low Temperature Long Time conditions of HoP are most effective in eradicating CMV.

High Temperature Short Time (HTST)

Maschmann et al. [40]

Mean viral infectivity was reduced by 100% at 72 degrees for 5 s.

HTST is effective at eradicating CMV. More evidence is needed to corroborate.

Microwave Irradiation

Mikawa et al. [20], Ben-Shoshan et al. [39]

Mean Viral Infectivity reduced by about 90% at 500 W, 30 s, and by 100% at 750 W, 30 s.

Microwave Irradiation is effective at eradicating CMV at high powers. More evidence is needed to corroborate.

UV-C Irradiation

Lloyd et al. [21]

Mean viral infectivity was reduced by 54.5%

UV-C irradiation can significantly reduce CMV but lacks efficacy to reduce it to non-transmissible levels. More evidence is needed to corroborate.

High Pressure Processing

Pitino et al. [9]

Mean viral infectivity was reduced to undetectable levels (manually estimated to >89% reduction in viral titres)

HPP reduces CMV significantly, but not as effectively as HoP or HTST. More studies are needed to corroborate.