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Date: | Thu, 21 Aug 2003 00:27:35 EDT |
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Ann writes: Our breastfed VLBW babies have a =
high incident of infection, feeding intolerances, smelly stools, etc. =
The nurses have lost faith in mother's milk for the preemies.
I would be very interested in more details Ann. Do these VLBW (very low birth
weight) babies have a higher incidence of infection than their counter parts
fed formula. Are they receiving mixed feeds. What type of infections? What is
the definition of feeding intolerance and what is your protocol for advancing
feeds? Is this increased infection rate a sudden change? If the milk is truly
contaminated your infectious disease team better quickly get their hands on
the pumps and culture them. Are you using hospital grade pumps where no milk
should be able to get into the motor? Breast milk is not a sterile fluid but
there are acceptable colony counts for certain bacteria. There is good info in
Lawrence on this. In a few instances where we've been concerned about
contaminated milk we've collected a clean catch from each breast. It sounds like you've
taught the mothers to use good technique to collect their milk. Are your
freezers working properly and are the refrigerators at the right temperature? Is
there something in the feeding method that could be causing a
problem--continuous feeds left in the tubing too long? My guess is if this is a true problem of
contaminated milk it's probably, as the nurses think, pump related. Somebody
better quickly culture those pumps.
Kathy Boggs, RN, IBCLC
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