Once a day soap and water washing might be very reasonable, but before 
every expression is overkill. Bacteria (and fungi) thrive in biofilms, 
which are only disrupted by soap and friction. This is why rinsing 
dishes does not get them as clean as rubbing them with your sponge or 
dishcloth. Bacteria can hide in protein films, and milk is rich in 
protein. It is also rich in immune compounds of many types, but they may 
not be able to penetrate a biofilm if chronic lack of soap and friction 
washing allows one to build up.

Since these moms are having to defend against hospital acquired 
pathogens as well, and were probably not born at home vaginally and 
exclusively breastfed by an uninterrupted line of female ancestors who 
were the same, and have been exposed to antibiotics, they probably don't 
have "normal" human flora anyway.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

On 9/20/2013 7:37 AM, Jan Barger wrote:
> Theresa says:
>   
>   
>   
> I'm a hospital based IBCLC and have a question about requiring all  NICU
> mothers to wash their breasts with soap
> and water before  expressing.  I recently spoke to our Infection Prevention
> Director who  mentioned that the  plan is
> to institute a policy requiring all our NICU  mothers to wash the breasts
> each time before expressing. She mentioned that she  has researched it and
> has found substantial evidence to support this  practice.
>
> We have always advised hand washing before  expressing, but not universal
> breast washing.
>
> I'm wondering if this is  current  best practice and advised?
>   
> ****************************************************************************
> *********************
>   
> Arghhhh....has that old chestnut resurfaced?  Do mothers have to  wash
> breasts and nipples before breastfeeding as well?  I would love to  see her
> "substantial evidence."  She may find articles that  state washing will reduce
> the number of bacteria on her breasts/nipples,  but the REAL bottom line
> question is, does the practice reduce the  morbidity and mortality of the
> babies?
>   
> "Back in the day..." (I'm allowed to say that because I'm OLD), we
> required all mothers who were breastfeeding -- the one a month or so we had back
> then -- to wash their nipples with green soap and rinse with sterile water
> before breastfeeding.  Imagine what this did to the mother's nipples and  her
> psyche.
>   
> Anyway, I could be mistaken, but I do not believe this is current
> acceptable practice for a host of reasons.  Washing hands -- absolutely --  think of
> where your hands have been and what they do.  Washing  breasts that are
> just hanging out in a  bra?  Why?
>   
> I'd ask your "Infection Prevention Director" just what she is  trying to
> accomplish thru this.
>   
> Jan Barger, RN, MA, IBCLC, FILCA
> Wheaton  IL
>
>
>
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