I am currently working with a lactating mother who is being treated for typhoid fever. Mom's blood culture was positive for salmonella typhi. Her baby was born at 30 weeks gestation due to complications r/t maternal fever/illness, and is now 10 days old and taking full feeds.

Mom has been expressing and storing her milk since day 3 postpartum. Baby initially received some feeds of pumped breastmilk before the source of mom's fever was identified. Baby did not develop any signs of infection.

However, our neonatologists are currently feeding the baby formula because a culture of mom's breastmilk came back positive for gram negative rods, which they are assuming is salmonella. A second culture taken 48 hours later is still pending.

Does anyone have experience with salmonella typhi in a mom pumping for a preemie? Do we really have to continue culturing milk until it comes back negative before this baby can have mom's pumped milk and/or begin to try breastfeeding? Should we discard the milk mom pumped already or would it be safe to feed to baby?

I can't find any studies or other articles that say yes, but I also can't find anything that says no. Currently, our NICU docs don't want to give this baby her mother's breastmilk. I'd appreciate any evidence, thoughts or experiences anyone could share, please.

Karen Meade, RN, IBCLC, LCCE
hospital-based Lactation Consultant
suburban Philadelphia, PA, USA 

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