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Subject:
From:
"Debbie Moses,Rn,Ibclc" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 22 Aug 1998 21:16:58 EDT
Content-Type:
text/plain
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text/plain (29 lines)
Dear Lactnetters:
Has anyone who works in a NICU had any dealing with mastitis & cultured
freshly expressed breastmilk growing the organism strep agalactiae (group B) ?
In our Intensive Care Nursery we have a set of 33 wk twin girls who as of last
Wed. were 13 days old & doing well.  Mom has been doing well with pumping. MOM
called me last Wed. morning with classic symptoms of a breast infection: fever
101, achy,
& very tender breast.  OB called & antibiotics started.
Around midday twin B took a turn for the worst & went into NEC (necrotizing
enterocolitis).  The neonatologist felt the coincidence of the NEC &
fever/mastitis was
enough to take Twin A off EBM & place npo.  She also said to discard the
thawed milk they were getting.  Then she wanted a culture of the EBM.  None
was thawed at this time.  When Mom came in we had her pump & cultured her
fresh milk.  Group B strep grew but no WBC's. Later we realized that the milk
the babies were receiving was 4-5 days older not the most current pumped.  The
DR didn't want us to thaw that & get a culture.  That would have been a truer
picture of what the babies were receiving (plan to check with the infection
control nurse on Monday about getting it cultured).  Has anyone had Group B
culture out of EBM?  Could this be in the milk or in the equipment?  The baby
went into full-blown NEC, had surgery but did not survive.  I'm also concerned
that the DR may have planted the seed of guilt in the Mom
that her milk may have caused this. If anyone can shed any help on this I'd
appreciate it.

TIA,
Debbie Moses, RN, IBCLC
Louisville, KY  hospital based LC

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