Most of the studies regarding human milk contamination and resulting
infections were done BEFORE any fortifiers were available.

Please note, that in addition to the published literature, some of us
neonatologists have personally cared for infants who have suffered ill
effects and yes, died, because of contaminated human milk. It is rare that
individual case reports are accepted by journals these days, nor do all of us
have the time to write, much as we would like to.  There is also the
temptation NOT to report the bad stuff (like breastfed infants dying of
dehydration) because we don't want to damage breastfeeding's reputation.

Almost invariably, it is not the fault of breastmilk or breastfeeding, but
our (health care workers) lack of knowledge or follow-up that is the problem.


In my case, a set of 27 week twins of a very young mother (who had not
intended to breastfeed, but whom I convinced to pump for 2-3 weeks) developed
enterobacter cloacae NEC and sepsis - 1 died.  When we introduced breastmilk
feedings again to the surviving twin, he again became ill.  At that time I
cultured the mother's freshly pumped breastmilk and found the same bug (no
symptoms of mastitis).  I and my lactation team obviously did not impress
upon this young woman the importance of good handwashing and pump
cleanliness.

Nancy
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA

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