Would like to know if anyone has info regarding acceptable colony counts
in breast milk a mom is providing for her hospitalized preemies. I have
a mom with 26 week twins now six weeks old. she completed 2 ten day
courses of keflex for mastitis and had recurrence 7 days after
completion. Her OB/GYN was puzzled. Skin on nipple areola red and flaky.
We all suspected yeast. Neonatologist requested skin and milk
cultures(including yeast cultures). Negative for yeast. milk and skin
cultures grew out staph aureus. Mom switched to Cipro. She has been
pumping and dumping since this all started per neonatologist request.
She was re-cultured after 6 days of Cipro and colony counts were done.
Milk had staph aureus with a colony count less than 10,000.
Neonatologist wants to know what is an acceptable colony count. The only
info I found was in Lawrence for donor milk. She states that no
potential pathogens should be found(staph aureus was among those
listed). She also lists other guidelines stating a count of
staphylococci of less than 100,000 is acceptable. The neonatologist is
uncertain as to how to proceed. The babies have a history of feeding
problems(increased girths and bloody stools) and have twice had to have
feeds withdrawn and then restarted again. Breastmilk is the only milk
they have received thus far. Mom still has frozen milk collected before
this all started and the neonatologist is allowing it to be used, but
she is concerned about milk collected since infection began. Mom has
approximately 150 volufeeds of frozen milk that is in question and does
not want to discard it. Does anyone have info that would be helpful?
Paula McRae,RN,IBCLC Lafayette,LA