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Date: | Tue, 5 Mar 1996 21:34:09 -0800 |
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Advice, friends, please.
Yesterday I recieved a call to the hospital lactation office from one of =
the nurse practitioners in the NICU and it has shaken some of my =
assumptions about advise to give moms of premies, etc. After 10+ years =
in that same NICU before my lactation training, that is a humbling =
experience. =20
The baby is a 12 day old now 28 week premie who is stable and =
transitioning to bolus feedings. The baby has recieved only his =
mother's milk since birth. Mom was just readmitted to another local =
hospital with overwhelming sepsis which was found to be caused by =
methcillin resistant staph. According to the PNP who called me, this =
was presumed to be the organism which had caused premature rupture of =
membranes and was "cooking" for the 12 days since the baby's birth. The =
baby has now been taken off mom's milk and put on formula due to mom's =
illness and the inability to "sterilize her skin sufficiently to obtain =
clean milk." I was told this is similar to what is done with a mom who =
has mastitis until she is on antibiotics 24 hours. There is not a =
written policy related to this and there are no routines for culturing =
mother's milk in our hospital. =20
My first impression was that one protection this baby had been =
getting from this organism was the immunities present in mom's milk. My =
second thought is how will we know when mom is well enough and that her =
milk will be clean enough if it is dangerous for the baby at this point. =
The PNP I spoke with said that her advise was based on what is done in =
Denver by Mariane Neifert. Is there anyone who can comment from that =
hospital, or anywhere else who has a (preferably) written policy or =
documentation.
Thanks in advance. tracy throckmorton, rn ibclc
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