I work in a level 3 NICU.  Really hoping you can help me. I am at a loss and not sure what to do...discouraged!  We have had 5  BSI's since March!  In the past there may have been maybe one every few months.  I had started pushing kangaroo care and we had seen an increase in both mom and dad enjoying this!  When these babies got the BSI...breast cultures were done and they found in all 5 cases the same organism baby/EBM was the same although different from dyad to dyad.  One of the reasons given for doing the EBM cultures is that if the hospital can find the source (not our fault)  they will not be 'dinged' and have to pay for the extra cost (Medicaid) So when these breastmilk cultures started coming back that is when I really started wondering about the bactoshield/avaguard treatment. All of these moms had been using these on her nipples. The previous LC has started this practice and I had been questioning it.  The only thing that they are saying has changed has been our increase in kangaroo care.  I had stopped the bactoshield practice about 2 weeks ago  ( on a whim looked in Hale and found it to be an L4!)  but was told by my manager yesterday that we have to go back to that.  They are also thinking of using some sort of 'wipe' on the moms chest prior to STS.  Help!!  What are your thoughts??  Any ideas, suggestions etc?  These moms were not our typical unclean moms.  Appreciate any insight you can give.  What are y'all doing?  What do you do when baby gets a BSI? 

Kim Reaser BSN, RN, IBCLC
 

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