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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References
Morales Y, Schanler RJ . Human milk and clinical outcomes in VLBW infants: how compelling is the evidence of benefit? Semin Perinatol 2007; 31: 83–88.
Hurst NM, Myatt A, Schanler RJ . Growth and development of a hospital-based lactation program and mother′s own milk bank. J Obstet Gynecol Neonatal Nurs 1998; 27: 503–510.
El-Mohandes AE, Schatz V, Keiser JF, Jackson BJ . Bacterial contaminants of collected and frozen human milk used in an intensive care nursery. Am J Infect Control 1993; 21: 226–230.
Eidelman AI, Szilagyi G . Patterns of colonization of human milk. Obstet Gynecol 1979; 53: 550–552.
Botsford KB, Weinstein RA, Boyer KM, Nathan C, Carman M, Paton JB . Gram-negative bacilli in human milk feedings: quantitation and clinical consequences for premature infants. J Pediatr 1986; 109: 707–710.
Godambe S, Shah PS, Shah V . Breast milk as a source of late onset neonatal sepsis. Pediatr Infect Dis J 2005; 24: 381–382.
Olver WJ, Bond DW, Boswell TC, Watkin SL . Neonatal group B streptococcal disease associated with infected breast milk. Arch Dis Child Fetal Neonatal Ed 2000; 83: F84–F89.
Cooke RP, Devlin J, Robinson MJ . Breast milk and methicillin-resistant Staphylococcus aureus. J Hosp Infect 1987; 10: 312.
Byrne PA, Miller C, Justus K . Neonatal group B streptococcal infection related to breast milk. Breastfeed Med 2006; 1: 263–270.
Widger J, O’Connell NH, Stack T . Breast milk causing neonatal sepsis and death. Clin Microbiol Infect 2010; 16: 1796–1798.
Ng DK, Lee SY, Leung LC, Wong SF, Ho JC . Bacteriological screening of expressed breast milk revealed a high rate of bacterial contamination in Chinese women. J Hosp Infect 2004; 58: 146–150.
Murray PR, Baron EJ, Phaller MA, Tenover FC, Volken RH . Manual of Clinical Microbiology 1995) 6th edn., ASM Press: Washington, DC.
Boo NY, Nordiah AJ, Alfizah H, Nor-Rohaini AH, Lim VK . Contamination of breast milk obtained by manual expression and breast pumps in mothers of very low birthweight infants. J Hosp Infect 2001; 49: 274–281.
Boer HR, Anido G, Macdonald N . Bacterial colonization of human milk. South Med J 1981; 74: 716–718.
Bjorksten B, Burman LG, DeChateau P, Fredrikzon B, Gothefors L, Hernell O . Collecting and banking human milk: to heat or not to heat? Br Med J 1980; 281: 765–769.
Goldman AS . Immunologic system in human milk. J Pediatr Gastroenterol Nutr 1986; 5: 343–345.
Gagneur A, Croly-Labourdette S, Gremmo-Feger G, Vallet S, Sizun J, Quentin R, Tandé D . Infected breast milk associated with late-onset and recurrent group B streptococcal infection in neonatal twins: a genetic analysis. Eur J Pediatr 2009; 168: 1155–1158.
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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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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DOI: https://doi.org/10.1038/jp.2011.13
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