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Breastmilk cultures and infection in extremely premature infants

R J Schanler1, J K Fraley, C Lau

  • 1Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center of New York at North Shore, North Shore University Hospital, Manhasset, NY 11030, USA. schanler@nshs.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 26, 2011
PubMed
Abstract

Insights

Routine bacterial cultures of expressed mother's milk (MM) do not predict infection in premature infants. These cultures are not useful for clinical management, despite MM being a potential source of infection.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Infectious Disease

Background:

  • Expressed mother's milk (MM) can harbor microbial species, raising concerns about its role in neonatal infections, particularly in premature infants.
  • Clinicians sometimes obtain bacterial cultures of MM to assess infection risk before infant feeding.

Purpose of the Study:

  • To investigate whether serial microbial cultures of expressed mother's milk can predict subsequent infections in premature infants.

Main Methods:

  • Milk microbial flora was analyzed using plate counts from 813 MM samples from 161 mothers of infants born before 30 weeks gestation.
  • Pathogens isolated from infants were compared with isolates found in their mothers' milk.

Main Results:

  • No correlation was found between microbial counts in MM and maternal factors or infant infection.
  • The presence of Gram-positive organisms in both milk and infant isolates did not significantly increase infection odds (OR 1.18).
  • Gram-negative organisms appeared sporadically in milk, with no clear predictive value for infant infection.

Conclusions:

  • Initial and random milk cultures do not reliably predict infection in premature infants.
  • Routine milk cultures lack sufficient data for effective clinical management.
  • The sporadic presence of certain microbes suggests common exposure routes for mother and infant.

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