I am a couple days behind, sorry, but hope you can use the following
thoughts:
Deb K you say "Our rooms are not clean, especially bathrooms. All too often
the pumps are not cleaned between pumpings or may be rinsed and left wet in
bathroom sinks. The information given to patients is inconsistent. The moms
are usually pumping for babies in the ICN (preemies and ill babies). They
are tired and stressed - I am worried this may become a major infection
control issue."
Deb you are right to worry. This is a major infection control issue. Read
chapter in Riordan & Auerbach BF and Human Lactation on premies I believe.
It tells of problems w/ infection. If you have a major outbreak or an infant
death, this would be a tragedy. and the tragedy would continue becoz
knee-jerk reactions can occur where breastpumping and brastmilk use are
prohibited by the powers that be. So it is best to be proactive and correct
this problem now. I believe the standard of care is
1. for well babies - start w/ sterile equipment, a clean pump is a given,
and good maternal hygiene and handwashing always, esp. after bathroom use,
baby diaper changing, peri pad changing etc. Then mom washes parts w/ hot
soapy water after each use, rinses well and dries on clean surface.
Sterilize once each 24 hr period.
2. For premies or sick babies - even more attention to hygiene [read the
chapter I mentioned above re the debate whethre to express first milliliters
of the milk], handwashing, clean pump etc. The equipmetn is sterilized after
each use.
Now how to accomplish this is the question. Some hospitals provide several
kits to the mom and she can sterilzie them at home and rotate them or the
hosp may do it. some nicu units have purchased a sterilizer or even
dishwasher. Protocols must be wriotten and enforced re cleaning of the pump.
If you took a swab and cultured the pump you would probably get all kinds of
grungy organiasms. This is one of my pet peeves. Some of the pumps are
pretty hard to really get clean and belive me I am a cleaning fanatic. If
the LC cant' do it, [you're there 2x per week] someone needs to be assigned
to do so and sign off on it. I have suggested to Medela several times
[medela are you listening?] to make some kind of clear thin plastic sleeve
that could go over the pump but that would have small holes for the kit
tubing to go thru. Then this plastic bag [like a newspaper sleeve, umbrella
bag, or dry cleaning bag ya know] could be changed and the spills etc
discarded. A clean pump would be left underneath. Sorry so long, but this
germ issue is very important, especially to compromised babies, and when bf
is not done the 'regular'way but w/ lots of pump use nowadays and day care
etc. risks.
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA
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