Are we ABSOLUTELY sure the mom had strep or staph IN THE MILK? Not on her skin and got into the milk by improper aseptic technique?
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Roosje van Gorp
Sent: Wednesday, January 13, 2010 1:37 PM
Subject: Re: EBM Cultures Positive Staph and Strep - NICU Premies
How about pasteurizing the milk?
Roosje van Gorp
Maastricht, The Netherlands
Laurie Beck wrote:
> Looking for resources to give good advice to mother with 26 weeker
> premie twins (now 32 weeks). Have mother's permission to post.
>
> Mother G1P1 delivered 26 week premie twins by c-section. 2 weeks of
> age babies in NICU developed UTIs and mother's milk decided source of
> infection. Mother's milk cultured positive strep. Mother treated
> amoxicillin and told to pump and dump. Retested mother's milk 1 week
> later and tested posted staph. Started Keflex and told to pump and
> dump milk.
>
> Mother did not receive instructions from NICU during first 4 weeks on
> sanitizing of pump parts, pumping protocol, how to establish
> breastmilk supply, and proper handwashing. Told to pump every 3 hours
> and bring milk to NICU.
>
> Mother has no history of positive for GBS, no mastitis, no sores or
> cracks on nipple area, no fever. Healthy and asymptomatic.
>
> As an IBCLC I am just now entering the picture and working on
> increasing milk supply which is going well. A mother with premies I
> stress the sanitizing of pump parts everyday and reviewed breastcare,
> handwashing, proper storing of milk and handling of containers. I have
> instructed mother to pump and freeze milk until we get good
> information on when to use her milk.
>
> One twin will be discharged to home in a few weeks and mother had
> never put the infant to breast for latching on practice.
>
> Information I am coming across is 24 hours after receiving antibiotic
> treatment it should be fine to use breastmilk from mother. What is
> best protocol? Do we toss all of the frozen milk? I also question if
> the first two cultures were not contaminated due to the collection process.
> Do we continue culturing mother's milk and make sure it is done
> correctly without contamination?
>
> One twin is doing very well and close to discharge. One twin developed
> NEC and is very sick. Mother has been told for weeks that her milk is
> the cause of the illnesses and that her milk cannot be used until it
> shows up negative cultures.
>
> Any help or resources would be appreciated.
>
> Laurie Beck
> Texas
>
> edge.dchstx.org made the following annotations
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