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Breastmilk cultures and infection in extremely premature infants

Journal of Perinatology volume 31, pages 335–338 (2011)Cite this article

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Abstract

Objective:

As expressed mother's milk (MM) is known to be colonized by microbial species, it is occasionally considered as a source of infection in premature infants, prompting some clinicians to obtain milk bacterial culture results before infant feeding. To determine whether serial microbial cultures of MM predict infection in premature infants.

Study Design:

Milk microbial flora was determined by plate counts from aliquots of MM obtained from 161 mothers of infants born <30 weeks gestation (n=209). Pathogens isolated from the same infant were tabulated.

Result:

Milk samples (n=813) yielded 1963 isolates. There were no relationships between microbial counts and maternal age, ethnicity, education, skin-to-skin contact and infant infection. In 64 infants, milk and pathological isolates had presumptively the same Gram-positive organism, yet the odds of infection before or after exposure to milk containing that Gram-positive organism were not significant (1.18; 95% confidence interval=0.51, 2.76). In eight infants, milk and pathological isolates had presumptively the same Gram-negative organism, which appeared sporadically in milk, either before or after isolation in the infant.

Conclusion:

Results of initial milk cultures do not predict subsequent culture results. Random milk cultures, even if obtained at any time during hospitalization, are not predictive of infection in premature infants. The sporadic nature of the appearance of certain isolates, however, suggests common exposure of both mother and infant. Routine milk cultures do not provide sufficient data to be useful in clinical management.

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Acknowledgements

We thank Pat Wilson MT (ASCP) for the microbiology laboratory work. We appreciate the assistance of Dr Martin Lesser of the Feinstein Institute for Medical Research of the North Shore-Long Island Jewish Health System. This study was supported by the National Institute of Child Health and Human Development, Grant No. RO-1-HD-28140 and the National Institutes of Health General Clinical Research Center, Baylor College of Medicine, Grant No. MO-1-RR-00188. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center of New York at North Shore, North Shore University Hospital, Manhasset, NY, USA

    R J Schanler

  2. Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA

    R J Schanler

  3. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    J K Fraley, C Lau & N M Hurst

  4. Department of Neonatology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA

    L Horvath

  5. Department of Pathology, Baylor College of Medicine and Gulf Coast Regional Blood Center, Houston, TX, USA

    S N Rossmann

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  1. R J Schanler
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Correspondence to R J Schanler.

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Schanler, R., Fraley, J., Lau, C. et al. Breastmilk cultures and infection in extremely premature infants. J Perinatol 31, 335–338 (2011). https://doi.org/10.1038/jp.2011.13

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