Low-temperature, long-time (LTLT) pasteurization assures the safety of banked human milk; however, heat can destroy important nutritional biomolecules. High-pressure processing (HPP) shows promise as an alternative for pasteurization of breast milk. The purpose of this study was to investigate the efficacy of HPP for inactivation of selected bacterial pathogens in human milk. Human milk was inoculated with one of five pathogens (10(8) to 10(9) CFU/ml), while 0.1% peptone solution solutions with the same levels of each organism were used as controls. The samples were subjected to 400 MPa at 21 to 31 degrees C for 0 to 50 min or to 62.5 degrees C for 0 to 30 min (capillary tube method) to simulate LTLT pasteurization. Tryptic soy agar and selective media were used for enumeration. Traditional thermal pasteurization resulted in inactivation (> 7 log) of all pathogens within 10 min. In human milk and in peptone solution, a 6-log reduction was achieved after 30 min of HPP for Staphylococcus aureus ATCC 6538. After 30 min, S. aureus ATCC 25923 was reduced by 8 log and 6 log in human milk and peptone solution, respectively. Treatments of 4 and 7 min resulted in an 8-log inactivation of Streptococcus agalactiae ATCC 12927 in human milk and peptone solution, respectively, while Listeria monocytogenes ATCC 19115 required 2 min for an 8-log inactivation in human milk. Escherichia coli ATCC 25922 was inactivated by 8 log after 10 min in peptone solution and by 6 log after 30 min in human milk. These data suggest that HPP may be a promising alternative for pasteurization of human milk. Further research should evaluate the efficacy of HPP in the inactivation of relevant viral pathogens.