Karen writes: < it seems to me that I recall one of our learned colleagues in Lactnet discussing the difficulty of obtaining valid milk cultures, because often what was really being cultured was the bacteria etc on the skin. Does anyone else remember this, and does it apply in the cases being discussed?> Again, Barbara Wilson-Clay's post, this time July 20, 2000. (Can you tell I have a separate file marked BWC??) In it, she shared with LN something sent to her by Melanie Ashworth: <For > lack of protocol, in desperation we decided on "clean, mid-stream catch". We > clean the breast, use clean gloves, and get the flow going, and then try to > get a spray into the jar. Getting a spray going first probably helps flush > off some skin flora. We collect in a urine specimen container... If we are > going for a particular duct that seems infected, we have the mom lean over > and try to get as many drops as possible from that duct into the jar. She > finds the most painful spots, we palpate the duct line, and express as gently > as we can but still getting a flow from that duct - or those particular ducts > - and have her lean over rather than have to scoop it up from the skin. > Because this milk is often inspissated, getting this can be a bit acrobatic. > Well worth it, it has led to a total re-think on some antibiotic regimens. I > have found that when I call a doc and make the recommendation they are > delighted with the option for some quantification and identification of > organisms. Makes them feel science can be applied to lactation, I guess. > (My staff and I love the little light-bulb of a 'duh' that goes on in their > brains when we suggest a culture.) > Excuse the private post - feel free to post to the list if you think it might > be helpful. > Melanie R. Ashworth RN, IBCLC > Program Director > Lactation Center, LPCH @ Stanford > *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html