How about culturing the pump parts? That is more often the source of
infection. We have a dedicated microwave, 1100 power. And we use the
micro-steam bags. The microwave is on an old bedside table and supplies are
in the drawers below. A 2nd table is beside it for work space and added
storage.
Wash the parts in hot soapy water, rinse well, put in a bag with 2 oz water
(measured in a feeding bottle), seal it up, and microwave for 1min 30 sec.
Pour out the hot water in a sink, and carefully, gloved put the clean pieces
on paper towels to drip dry, or as a holding place while mom assembles them
for use again. The tubing can be sterilized also, but must be done
separately. Read directions. We started this when we discovered that it is
not possible to order sterile nipple shields from anyone any more. The bags
can be used many times, but we label them for that one mother and it is hers
to reuse as needed. For a NICU mom, probably weekly is enough. But when
active infection is of concern, daily is a do-able thing.
Did they actually swab the mothers' chests or hands to see if that is the
real source?
Phyllis
Phyllis Adamson, BA, IBCLC, RLC
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Kim Reaser
Sent: Saturday, June 18, 2011 5:10 AM
To: [log in to unmask]
Subject: Breast cultures and BSI's
I work in a level 3 NICU. Really hoping you can help me. I am at a loss and
not sure what to do...discouraged! We have had 5 BSI's since March! In
the past there may have been maybe one every few months. I had started
pushing kangaroo care and we had seen an increase in both mom and dad
enjoying this! When these babies got the BSI...breast cultures were done
and they found in all 5 cases the same organism baby/EBM was the same
although different from dyad to dyad. One of the reasons given for doing
the EBM cultures is that if the hospital can find the source (not our fault)
they will not be 'dinged' and have to pay for the extra cost (Medicaid) So
when these breastmilk cultures started coming back that is when I really
started wondering about the bactoshield/avaguard treatment. All of these
moms had been using these on her nipples. The previous LC has started this
practice and I had been questioning it. The only thing that they are saying
has changed has been our increase in kangaroo care. I had stopped the
bactoshield practice about 2 weeks ago ( on a whim looked in Hale and found
it to be an L4!) but was told by my manager yesterday that we have to go
back to that. They are also thinking of using some sort of 'wipe' on the
moms chest prior to STS. Help!! What are your thoughts?? Any ideas,
suggestions etc? These moms were not our typical unclean moms. Appreciate
any insight you can give. What are y'all doing? What do you do when baby
gets a BSI?
Kim Reaser BSN, RN, IBCLC
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