At MIHS/MMC, we do couplet care when MRSA is involved and mom is still an inpatient. We do place them in their own room, away from other couplets. And we do encourage direct BFing &/or pumping and feeding mom's EBM to her own baby and they are both treated for the infection. Standard Contact Precautions are always used. 

If we have more than one MRSA infant, we house them together, away from non-infected infants. If mother is not infected, she must also glove and gown, just like the nurses when they handle the babies. What I can't say is: considering Contact Precautions, can mom directly breastfeed, or must she only pump and bottlefeed?

Yes, baby has already been exposed because of the pregnancy. There may be MRSA in the milk, possibly from a breast infection, but there are also antibodies in the milk to protect baby. I don't think there has been a case of baby getting MRSA via its own mother's milk.

If mom can visit and hold her baby, she can breastfeed and/or provide her breast milk. Why replace it with something that has NO anti-infective factors?

We also had a mother who developed MRSA after a C/S and her baby was in Level II. We had her pumping and providing her milk, but she could not visit in the nursery as a protection for the other babies. Her baby was in an isolette and was handled with Contact Precautions and fed mom's EBM as it was delivered from her room.

Phyllis

---- BRENDA PHIPPS <[log in to unmask]> wrote: 
> Hello,
> 
> In my SCN we had a newborn transported in by air from another community on 
> the Navajo reservation. Mother had a history of being treated for MRSA in 
> 7/06, while pregnant. Infant at one day old was showing signs of respiratory 
> distress and infection (labs are pending). The NNP and neonatologist have 
> decided that this infant must be fed formula until mother's labs come back 
> normal - the reason being that MRSA can be transmitted to the infant via 
> breastmilk.
> 
> I am thinking that this infant has already been exposed, and that this is 
> completely unnecessary. Please any other feedback on how to talk to these 
> HCPs would be greatly appreciated.
> 
> Brenda Phipps, BS, IBCLC
> 
 
--
Phyllis Adamson, IBCLC, RLC
Glendale, AZ.
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