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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