In a message dated 7/19/2007 7:39:39 PM Pacific Daylight Time,  
[log in to unmask] writes:

isolated  Klebsiella and  Acetinobactor 

There should be no gram negatives (Klebsiella) in pumped breastmilk.   
Acinetobacter (correct spelling) is commonly found on the skin of normal people  and 
is commonly found in breastmilk.  
 
You must review handwashing and pump cleaning with the involved  mothers.  It 
is not necessary to culture every mother's breastmilk (AAP Red  Book).  
"Rule-out" NEC episodes occur commonly because many physicians do  not understand 
the normal immaturity of the premie gut. 
 
If an infant has true NEC (large residuals > 50 % of prior feed,  abdominal 
distention, bloody stools, X-ray changes) I would culture the mother's  milk - 
both with and without the added fortifier.

 
Nancy E.  Wight MD, IBCLC, FABM, FAAP
Neonatologist
Medical Director, Lactation  Services
Sharp Mary Birch Hospital for Women
San Diego, CA  USA
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