Looking for resources to give good advice to mother with 26 weeker
premie twins (now 32 weeks). Have mother's permission to post. 

Mother G1P1 delivered 26 week premie twins by c-section. 2 weeks of age
babies in NICU developed UTIs and mother's milk decided source of
infection. Mother's milk cultured positive strep. Mother treated
amoxicillin and told to pump and dump.  Retested mother's milk 1 week
later and tested posted staph. Started Keflex and told to pump and dump
milk. 

Mother did not receive instructions from NICU during first 4 weeks on
sanitizing of pump parts, pumping protocol, how to establish breastmilk
supply, and proper handwashing. Told to pump every 3 hours and bring
milk to NICU. 

Mother has no history of positive for GBS, no mastitis, no sores or
cracks on nipple area, no fever. Healthy and asymptomatic.

As an IBCLC I am just now entering the picture and working on increasing
milk supply which is going well. A mother with premies I stress the
sanitizing of pump parts everyday and reviewed breastcare, handwashing,
proper storing of milk and handling of containers. I have instructed
mother to pump and freeze milk until we get good information on when to
use her milk. 

One twin will be discharged to home in a few weeks and mother had never
put the infant to breast for latching on practice. 

Information I am coming across is 24 hours after receiving antibiotic
treatment it should be fine to use breastmilk from mother. What is best
protocol? Do we toss all of the frozen milk? I also question if the
first two cultures were not contaminated due to the collection process.
Do we continue culturing mother's milk and make sure it is done
correctly without contamination?

One twin is doing very well and close to discharge. One twin developed
NEC and is very sick. Mother has been told for weeks that her milk is
the cause of the illnesses and that her milk cannot be used until it
shows up negative cultures. 

Any help or resources  would be appreciated.  

Laurie Beck
Texas 

edge.dchstx.org made the following annotations
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