At our facility, the only time we are concerned about the CMV status is
with the micropremi who is most at risk. In these cases our neos discuss
with mom their concerns and with mothers permission, test the mom's for
cmv. If the mother is positive they do not permit use of breastmilk until
the infant is much larger. Freezing is only partially effective to
inactivate the CMV. The option is to use donor milk first and then formula
if the mother does not approve donor milk. I hate it but we have had a
couple of cases where there were very stong implications of adverse
responses related to  CMV exposure in LBW infants. There was a very good
study done in Germany recently that discussed this. My neo's strongly feel
that this is a significant concern here also but just not fully addressed
yet. Unfortunatly we do not have the ability to begin short term
pasturization of materal milk in our unit which is the "gold standard" for
inactivating CMV without reducing the breastmilks beneficial properties.
Lisa J RN CLE IBCLC

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