Bacterial Contamination of Mechanically Extracted Breast Milk

Mense, Lars; Rößler, Susann; Hanusch, Regina; Roßberg, Cornelia; Rüdiger, Mario

doi:10.1055/s-0033-1348028

Cited by 15 publications

(8 citation statements)

References 34 publications

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“…Literature data demonstrate that the contamination with potentially pathogenic bacteria of expressed human milk in NICU can achieve the 40%, however, there are no specific guidelines regarding mother's milk bacteriological testing and acceptable contamination (34). Our results showed that among all samples of raw mature milk, the 15% had positive culture at baseline but this colonization remained stable during the first 72 hours of refrigeration without showing an increase in bacterial load.…”

Section: Discussionmentioning

confidence: 99%

Effect of Target Fortification on Osmolality and Microbiological Safety of Human Milk Over Time

Piemontese

Liotto

Menis

et al. 2020

J. pediatr. gastroenterol. nutr.

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Objectives: The fortification of human milk can result in increased osmolality, which may be associated with adverse effects for preterm infants. To evaluate the effect of target fortification on the osmolality and microbiological safety of donor human milk and raw mature milk during the first 72 hours of storage. Methods: We performed target fortification of 63 pasteurized donor human milk (PDHM) and 54 raw mature milk (RMM) samples in a laminar flow hood. Osmolality (mOsm/kg) was evaluated before fortification (T0), immediately after fortification (T1), at 6 (T2), 24 (T3), 48 (T4), and 72 hours (T5) after fortification. Microbiological analysis was performed at T0, T4, and T5. During the study, all samples were stored at 4°C. Results: Mean osmolality at each study point for PDHM and RMM were, respectively: T0: 291.4 ± 11.0 versus 288.4 ± 5.6 (P = 0.06); T1: 384.8 ± 16.7 versus 398.3 ± 23.7; T2: 393.9 ± 17.7 versus 410.1 ± 27.0; T3: 397.8 ± 17.6 versus 417.9 ± 26.1; T4: 400.0 ± 16.5 versus 420.2 ± 24.9; T5: 399.6 ± 16.5 versus 425.2 ± 25.8 (P < 0.001 from T1 to T5). Microbiological analyses were negative at each study points for PDHM. At T0 16.1% of RMM samples had positive cultures, whereas the bacterial count remained stable thought the study. Conclusions: PDHM's osmolality increases during the first 6 hours after fortification and remains stable and safe until 72 hours. RMM's osmolality increases during the first 24 hours and remains stable and safe until 72 hours. The storage at 4°C and the manipulation of PDHM and RMM samples in a laminar flow hood seem to be safe and preserve the microbiological safety of fortified pasteurized human milk until 72 hours.

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Section: Discussionmentioning

confidence: 99%

Effect of Target Fortification on Osmolality and Microbiological Safety of Human Milk Over Time

Piemontese

Liotto

Menis

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…In another study, microbiological testing of EBM identified bacterial growth in 75% of samples. 16 The relatively high rate of EBM contamination in the present study is attributed to the multiple gaps in the processes of milk expression, storage and transport. It is important to note that in spite of the fact that mothers were instructed about the technical and hygienic aspects of breast milk expression, the compliance rate was not satisfactory.…”

Section: Discussionmentioning

confidence: 67%

Expressed Breast Milk Contamination in Neonatal Intensive Care Unit

Gad¹,

Sheta²,

Al-Khalafawi³

et al. 2021

PHMT

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Background The health benefits of breastfeeding are well known. However, some ill babies including those admitted to the neonatal intensive care unit (NICU) cannot be directly breastfed. In this situation, expressed breast milk (EBM) can be used. However, breast milk is not always sterile and may be contaminated by many microorganisms. EBM contamination is probably attributed to improper technical and hygienic factors and may pose significant threats to the newborn baby. The present study aimed to document the prevalence of EBM contamination in NICU and to uncover the relevant risk factors. Subjects and Methods The study included 118 mothers who could express breast milk for their own neonates admitted to the NICU. A checklist was used to document the steps the mothers followed during expression of milk and all steps of handling until the EBM reached the NICU. A 1 mL sample of EBM was obtained and sent to the microbiology laboratory within 20 minutes. Data obtained from the present study are expressed as number and percentage or mean ± standard deviation (SD). Statistical calculations were computed using SPSS 25. Results In the present study, 106 (89.8%) out of the assessed 118 EBM samples were contaminated. Hygienic factors related to EBM contamination included hand only wash, possible recontamination of hands during turning taps off, lack of using cotton pads or cloth piece on nipple and breast cleaning by water only. Other factors related to EBM contamination included container cleaning by water only, fresh milk refrigeration after > 4 hours, adding freshly expressed warm breast milk to refrigerated milk expressed earlier in the same day, milk transport in plastic bags with ice packs and longer transportation time. In the contaminated samples, the most commonly isolated organisms included Staphylococcus aureus (55.7%), Staphylococcus epidermidis (21.7%) and Enterobacter (11.6%). Conclusion The present study identified bacterial contamination in about 90% of EBM samples delivered to NICU infants. Factors related to EBM contamination include hygienic, storage and transport factors.

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“…There are four species isolated: Staphylococcus coagulase, Escherichia coli, Klebsiella pneumoniae and Streptococcus faecalis. Mense et al (2013) observed the bacterial contamination of mecanically extracted breast milk in 50 mother including species of Staphylococcus coagulase, Escherichia coli, Klebsiella pneumoniae and Streptococcus faecalis. The other species were Staphylococcus aureus, Alpha-hemolytic streptococci and dermal bacteria.…”

Section: Discussionmentioning

confidence: 99%

Microbiological Assessment of Fresh Expressed Breast Milk on Room Temperature at Dr. Soetomo Hospital Neonatal Unit

Widjaja

Hardiyani

Hanindita

et al. 2021

FMI

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Storing EBM at room temperature in several hours before consuming, frequently found in Indonesia. Based on Academy of Breastfeeding Medicine guidelines EBM can last for 6 to 8 hours in room temperature (25oC or 77oF). However, currently there hasn’t been study in tropical country especially Indonesia for the guidelines. This study aimed to assess microbiological quality of EBM on room temperature, including bacterial growth and major bacterial found on EBM for health care and society recommendations. An observational study of 30 expressed breast milk samples provided by 30 healthy women with term baby below 6 month old. The samples were kept sterile and laid at plates for 0 hours, 2 hours, 4 hours and 6 hours in room temperature (26°-32° C) and used drop plate technique on several culture media. Data was analyzed by Chi-square and paired sample T-test. Thirty of unheated fresh EBM from 30 lactating mothers were stored at room temperature, examined for the degree of bacterial contamination at 0 hour, 2 hours, 4 hours, and 6 hours. All the EBM samples were contaminated at 2 hour. Bacterial species identified was Coagulase-negative Staphylococcus (CNS), Escherichia coli, Klebsiella pneumoniae and Streptococcus faecalis, range of growth 109 cfu/ml-63 x 109 cfu/mm3 after 6 hour of storage. The EBM exposed at room temperature (30-36 0C) for more than two hour reduce the quality and do not recommended to be given to the infants.

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Bacterial Contamination of Mechanically Extracted Breast Milk

Abstract: High concentrations of bacteria are frequently observed in expressed breast milk. The study provides evidence that these bacteria are in the breast milk directly after emission. The pumping procedure and further transportation to the milk bank are of no influence.

Cited by 15 publications

References 34 publications

Effect of Target Fortification on Osmolality and Microbiological Safety of Human Milk Over Time

Effect of Target Fortification on Osmolality and Microbiological Safety of Human Milk Over Time

Expressed Breast Milk Contamination in Neonatal Intensive Care Unit

Microbiological Assessment of Fresh Expressed Breast Milk on Room Temperature at Dr. Soetomo Hospital Neonatal Unit

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