Hi all,

I'm currently no-mail, so please respond privately as well as to the list.

An LC in one of our NICUs called and asked me to post this question to y'all.
I already checked the archives & got a couple of references about GI flora,
etc. & breastmilk, but nothing that specifically addresses this problem.

She says their NICU has had 3 cases of NEC (necrotizing enterocolitis) in
babies being fed expressed milk.  The neonatologists are wondering if it could
be caused or aggravated by bacteria in the milk, possibly from "contaminated"
or poorly cleaned pump kits.  Her question is, has anyone else had problems
with bacteria in breastmilk?  What are your current guidelines for cleaning
pump kit parts, and for collecting milk to minimize contamination?

In the latest case, mom had mastitis and her milk was cultured and shown to
contain Group B strep.  Baby was 28 weeks.  The particular sample of milk
cultured was pumped 2 days before mom spiked a temp, and the milk WAS stored
in the hospital freezer for a few weeks before it was tested.  Could the
contamination have come from: a) pumping technique? b) the milk itself? c) the
hospital freezer or d)culture collection technique?

Is there any previous research on the effect of giving bacteria-laced milk to
preterm infants when mother has mastitis?  NOTE:  baby grew Staph aureus, NOT
GBS!  Mother is one who practices scrupulous hygiene when pumping (boils parts
daily, does good handwashing, etc.)  Baby was also getting HMF ("human milk
fortifier").  ALSO, the baby's twin was x-rayed prophylactically when the
first baby was diagnosed, and twin #2 was found to have dilated loops of
bowel, so was immediately taken off all po feeds and was treated with
antibiotics preventively.  The first twin is critical and will probably not
make it...

The nurse called Rochester & they said don't give milk until GBS cleared or
the source of contamination is found.  What recommendations would you have for
this mother, and for policies to prevent future problems?

TIA for all your feedback!

Carol in St. Louis