I knew it was Out There somewhere, so I went to Google and searched
"conjunctivitis and milk" though I didn't need the 'and'. Here's the cut
and paste:

http://www.sums.ac.ir/IJMS/9812/pishva9812.html

Short Communication

APPLICATION OF TOPICAL BREAST MILK FOR PREVENTION OF NEONATAL
CONJUNCTIVITIS

N. Pishva,* M. Mehryar**, H. Mahmoudi, R. Farzan

*Division of Neonatology, Department of Pediatrics, **Department of
Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran


ABSTRACT The effect of topical application of human breast milk in
prevention of neonatal conjunctivitis was determined. Five hundred and
sixty-five newborns were randomized into two groups, the first group
consisting of 327 newborns, received topical breast milk prior to each
breast feed for the first ten days of life. The second group of 238 babies
received no treatment and served as control. Conjunctivitis appeared in
9.1% of babies in group 1 and 25.6% of newborns in the control group (p <
0.00001). The most common microbial cause of conjunctivitis in both groups
was coagulase positive Staphylococcus. Regarding the predominance of
environmental micro-organisms as etiology of conjunctivitis in newborns and
anti-inflammatory and antimicrobial properties of human milk, topical
application of breast milk as a prophylactic measure in neonatal
conjunctivitis is recommended.
Irn J Med Sci 1998; 23(1&2):55


Keywords: Neonatal conjunctivitis, breast milk, prophylaxis
Recently the use of silver nitrate for prevention of neonatal
conjunctivitis has become the subject of controversy.1,2 Although many
countries use topical antibiotics instead of silver nitrate, in several
others such as Britain, no prophylaxis is given to the neonates, and in
some including Sweden, prophylactic agents are used only for those whose
mothers have not received good prenatal care.1,2

Studies in the past decades have proved that human milk is a potent
immunocompetent agent containing a rich variety of products, each of which
has a role in immunologic protection of infant.5

To determine the possible benefits of breast milk in reducing the incidence
of neonatal conjunctivitis, 565 normal newborn infants were randomized into
two groups, namely "case", consisting of 327 newborns who received topical
breast milk, and "control" composed of 238 neonates who received nothing.

All mothers of the "case" group newborns, were requested to instil one drop
of their breast milk into each eye of the baby prior to each breast feed
(at least four times a day) after washing and drying the nipples with tap
water, for the first ten days.

The mothers were requested to bring their babies for follow-up on the third
and tenth days or whenever the child developed any sign of conjunctivitis.

The control group had the same follow-up program. At each follow-up
session, neonates were examined for any sign of conjunctivitis. With any
sign of conjunctivitis, the baby was excluded from the study and received
the appropriate treatment.

We found that 91 of 565 babies (16.1%) developed neonatal conjunctivitis.

The rate of conjunctivitis neither depended on the sex nor the type of
delivery (i.e., cesarean section vs. normal), or birth weight of neonates.
The disease also had no correlation with maternal peripartum fever,
prolonged rupture of membrane, urinary tract infection or history of
itching/vaginal discharge during the third trimester of pregnancy.

Thirty (9.2%) out of 327 in the "case" group and 61 (25.6%) of 238 neonates
in "control" group developed conjunctivitis (p<0.00001).

The most frequent organism isolated from patients in both groups was
Staphylococcus aureus (58.3%).

In many countries particularly in the Middle East, western South America
and northern Africa, mothers put breast milk in the eyes of their infants
to treat overt infections.4 Breast milk is costless, easy to use and
culturally acceptable in many societies. These characteristics in addition
to immunologic properties of human milk on the one hand, and the important
role of environmental organisms in creating conjunctivitis1,3,6 during the
first 10 days of life which needs prophylaxis, on the other hand, made an
acceptable theoretical reason to use topical breast milk as a prophylaxis
against neonatal conjunctivitis.

Considering the limited duration of efficacy of one drop of breast milk in
prophylaxis against neonatal conjunctivitis, the mothers are advised to
instil one drop of their breast milk prior to each feeding into each eye of
their newborn after washing and drying the nipples, during the first 10
days of life. This protocol provides continuous prophylaxis against
invading organisms during this period of time.


References
1 Chandler JW: Controversies in ocular prophylaxis of newborns. Arch
Ophthalmol 1989; 107: 814-5.

2 Chen JY: Prophylaxis of ophthalmia neonatorum. Pediatr Infect Dis J 1992;
11: 1026-30.

3 Isenberg Sh J, Apt A, Yoshimori R, et al: Povidone Iodine for ophthalmia
neonatorum prophylaxis. Am J Ophthalmol 1994; 118: 701-6.

4 Newman J: How breast milk protects newborns. Sci Am: 1995; Dec. 76-9.

5 Nsanze H, Dawodu A, Usmani A, et al: Ophthalmia neonatorum in United Arab
Emirates. Ann Trop Paediatr 1996; 16: 27-32.

6 Pishva N, Mehryar M, Azarm N: Topical 2.5% betadien eye drops in
prevention of neonatal conjunctivitis. The first congress in perinatalogy,
UAE, Abudhabi, 1998.

_______________________________



--- Phyllis Adamson, IBCLC
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