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PubMed1996

Mother's own expressed breast milk: guide-lines for storage.

Guide-lines for milk collection and storage must aim to provide human milk with a composition as similar as possible to that stored within the human breast. The way in which milk is collected and stored has a significant effect on milk composition. Polyethylene storage bags should not be used to store milk for hospitalized infants. Glass containers fitted with an air-tight seal maintain immunoglobulin stability, and minimise fat loss.

Breast Feeding↗
PubMed2001

Contamination of breast milk obtained by manual expression and breast pumps in mothers of very low birthweight infants.

The objective of this study was to compare the rates of bacterial contamination of expressed breast milk (EBM) obtained by manual expression and breast pumps in mothers of very low birthweight (VLBW) infants (<1501 g). This was a randomized, controlled study carried out on 28 mothers of such babies and 92 specimens of EBM were collected: 41 specimens from 13 mothers assigned to the manual group and 51 specimens from 15 mothers in the breast-pump group. EBM was cultured quantitatively by the Miles and Misra method. Breast milk expressed by breast pumps (86.3% or 44/51 specimens) had a significantly higher rate of bacterial contamination than milk expressed by the manual method (61.0% or 25/41 specimens) (P= 0.005). When breast milk was expressed in the hospital, there was no significant difference in contamination rates between the two methods. When breast milk was expressed at home, the rates of bacterial contamination by staphylococci (P= 0.003) and Gram-negative bacilli (P= 0.002) were significantly higher in the breast-pump group than the manual group. In conclusion, the rate of bacterial contamination of EBM of mothers of VLBW infants was high, especially when EBM was obtained by the breast pump or when expression was carried out at home.

Adult↗
PubMed1994

Sodium in hand and pump expressed human breast milk.

Sodium content was analysed in the expressed breast milk from 30 mothers. Measurements were taken up to 24 days postpartum, during which time the mothers expressed manually or by means of a pump. Statistical analysis has confirmed not only the known decline in sodium levels postpartum but has also shown a significantly higher sodium content in manually expressed milk compared to that from pump expressed milk. This finding suggests that the method of expression may alter the sodium concentration in human breast milk, thus potentially reducing the amount of sodium supplementation required by some preterm infants.

Cross-Over Studies↗
PubMed1984

Storage of human breast milk.

The bacteriologic content of expressed breast milk was studied in 30 mothers at the time of expression and after 24 and 48 hours of refrigeration. There were no significant differences in colony counts between the three time intervals. All samples contained Staphylococcus epidermidis. In addition, eight other species were found, including four which were gram-negative. All samples contained less than 10(6) colonies/ml, and there were no significant differences in mean colony counts between samples expressed at home and at the hospital. We conclude that it is bacteriologically safe to refrigerate expressed breast milk for up to 48 hours.

Adult↗
PubMedDate not supplied

[Bacterial contamination of breast milk collected through manual expression and stored at room temperature]

OBJECTIVES: To the determine the bacterial contamination profile of unheated expressed breast milk, collected without rigid hygienic precautions and stored at room temperature for nine hours. The purpose was to give poor lactating mothers the alternative of storing their own milk out of refrigerator. A research on cultural, social and economical aspects as well as on donatorś knowledge about breastfeeding was considered necessary. METHODS: 35 donators were interviewed and an experimental investigation was performed with 33 samples of breast milk stored at room temperature (17 masculine C to 30.5 masculine C) and bacteriologically analyzed at zero, three, six and nine hours after collection. The same breast milk was stored at refrigerator (2 masculine C to 6 masculine C) as a control procedure. Total count of bacterial contents and identification of Staphylococcus aureus and Escherichia coli were evaluated.RESULTS: The enterviews revealed the low socio-economical and cultural level of lactating mothers and their little experience in expressing, collecting and using their own milk. Bacteriological data analysis showed mesophyllous average of 7.1x10(3)UFC/mL, acceptable outline of bacterial contamination, despite the use of a simplified hygiene technique. After nine hours, samples stored at room temperature showed final average of bacterial contents similar to the first ones (7.3x10(3)UFC/mL) and without relevant statistic differences from the ones kept under refrigeration (p=0.05) for studied bacterias.CONCLUSION: This study shows that it is possible to use unprocessed breast milk for babýs consumption if it is stored at room temperatures until nine hours after it has been collected. However, mothers have to be told about the possibility of storing breast milk for babies later consumption.

Journal Article↗
PubMed2004

Teaching mothers to express and store breast milk.

Reasons for expressing milk vary from mother to mother. Those who breast feed may be more likely than other mothers to return to paid employment outside the home. To assist mothers to continue with exclusive breast feeding, health professionals should provide information antenatally about expressing milk. Mothers can start to express from birth and should be encouraged by health professionals to pump or express milk on a frequent basis--"the more the better"--as this will help to establish lactation and increase the milk supply. The use of pumps and the storage of breast milk are discussed.

Adult↗
PubMed2000

Feeding outcomes and influences within the neonatal unit.

This study examined the feeding intention of mothers (n = 100), and the factors and beliefs, and changes in those factors or beliefs that influenced their choices, in the challenging environment of the neonatal unit. Mothers' experience and the frequency of nurse-assisted feeding activities were examined in mothers intending and not intending to breast-feed on discharge. Eighty-one per cent of mothers were either partially or fully breast-feeding or intending to do so on discharge. The most important factors identified as influencing this feeding choice included personal choice, with other influences being special benefits, more natural and feeling closer to the baby. Experiences such as infants receiving their first sucking feed from either the breast or bottle (inclusive of breast milk) and mothers expressing breast milk more frequently, were found to be significantly different and increased in frequency, in mothers intending to breast-feed. Differences in the mean weighted total daily nurse-assisted feeding score confirmed that these activities varied with gestational age (< or = 32 weeks [2.57], 32 to less than 35 weeks [3.86], and > or = 35 weeks [4.91]; F = 7.04, d.f. 55, P = 0.002), although there was insufficient power to determine differences between breast-feeding and non-breast-feeding mothers. The use of the Feeding Activities Calendar may have contributed to increased activity and high levels of breast-feeding in this preterm group.

Adult↗
PubMed2000

Contamination of expressed human breast milk with an epidemic multiresistant Staphylococcus aureus clone.

Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are a major cause of outbreaks in intensive care units. Infants make up a sector of the population that presents a high risk for MRSA infections. Mother-to-infant transmission has been indicated as a possible cause of MRSA infections in neonates. The occurrence and characteristics of MRSA in samples of banked human milk were investigated by selective culture, antibiogram and pulsed-field gel electrophoresis. MRSA contamination was found in 11% of 500 samples of expressed, fresh-frozen milk from 500 different donors at five Brazilian milk banks. The great majority of the contaminated samples passed breast milk quality control criteria for dispensing as raw milk under Brazilian and American guidelines. Most of the MRSA isolates belonged to the Brazilian epidemic clone, which is reported to be widespread in several Brazilian states, in Argentina and in Portugal. It is concluded that expressed breast milk can be a reservoir of multiresistant S. aureus epidemic clones. Studies are necessary to assess the source of contamination and potential role of MRSA-contaminated milk in the transmission of MRSA to neonates.

Anti-Bacterial Agents↗
PubMed2004

Antimicrobial-resistance and enterotoxin-encoding genes among staphylococci isolated from expressed human breast milk.

Resistance traits and the presence of enterotoxin-encoding genes were investigated in staphylococcus isolates obtained from expressed human breast milk. A total of 54 staphylococcal isolates identified as Staphylococcus epidermidis (53.6 %), Staphylococcus warneri (20.4 %), Staphylococcus haemolyticus (13 %) and Staphylococcus aureus (13 %) were investigated. By using a disc-diffusion method, higher rates of resistance, including intermediate resistance, were observed for penicillin (87 %) and erythromycin (59.3 %). All strains were susceptible to clindamycin and vancomycin. Minimal inhibitory concentration (MIC) was determined by a macrodilution method for four clinically relevant antimicrobial drugs. High rates of resistance or intermediate resistance were observed for erythromycin, gentamicin and oxacillin. Additionally, three isolates showed reduced susceptibility to vancomycin (MIC, 8 microg ml(-1)). Genetic determinants of resistance were detected by using PCR and the results showed good correlation with the macrodilution tests. Moreover, in four staphylococcus isolates, the presence of enterotoxin-encoding genes (seg, seh and sea) was identified. The results demonstrated that expressed human breast milk can be a reservoir of multiresistant staphylococci that may also harbour important virulent determinants.

Anti-Bacterial Agents↗
PubMed1980

Cord blood and breast-milk antibodies in neonatal rotavirus infection.

Studies were carried out during an outbreak of rotavirus type 2 infection in a neonatal nursery to determine the protective role of antibodies in cord blood and breast milk. The range, distribution, and geometric mean titres of rotavirus-specific antibody in the cord blood were similar among rotavirus-positive and rotavirus-negative neonates, and the amount of virus excreted did not correlate with antibody levels. Despite the protective effect of breast feeding, the pattern of rotavirus-specific IgA and IgG antibodies in the expressed breast milk of mothers of babies who were rotavirus excreters and non-excreters was similar. Nevertheless, a higher proportion of expressed breast milk samples contained rotavirus-specific IgA group 2 (92%) and type 2 (97%) specific antibodies than type I (67%) antibodies, and the geometric mean titres of group 2 and type 2 specific antibodies were tenfold higher than type I antibodies. Among breast-fed babies who excreted rotavirus there was no correlation between type 2 rotavirus-specific IgA antibodies in expressed breast milk and the amount of neonatal virus excretion. These studies suggest that factors other than the rotavirus antibodies in expressed breast milk are of importance in preventing rotavirus infection in newborn infants.

Antibodies, Viral↗