Kim, Although I do not have the Science to help back up your thoughts, I agree 100% with you. I was a NICU RN and now an IBCLC and I personally feel that 2 things can affect Bacterial counts in EMM. The way the mother cleans and handles her equipment, i.e. pump and kit and the way the EMM is handled once it hits the NICU, I have yet to see a NICU, and I have seen a few, that has a consistent or efficient policy in terms of keeping the EMM clean and separate from dirty hands and equipment in the NICU.  I am trying to no avail to have our hospital purchase bottle warmers for each Bed, that can be sterilized after the Baby is discharged and a new Baby comes in, and a separate sink area with a microwave for Breast Pumping mom's to be able to clean their equipment while visiting. As it is now the EMM gets dragged all over the place, on questionable surfaces, from what I observe and warmed up with practices I shudder to think of, like microwaving tap water in a jug and floating the bottle in it to warm it up, URGH! And of course we know what brought us MRSA and super bugs in the first place, the Nuclear theory, just kill everything, including the healthy Bacteria, so clearly that has gotten us nowhere. Lisa Mooney CNM MSN IBCLC 		 	   		  
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