Impact of breast milk expression practices on expressed breast milk contamination - cross-sectional study.

Ashwini Kurtakoti; Dr.Shivakumar N Hadli; Laxminarayan

doi:10.51168/j57gmj02

Authors

Ashwini Kurtakoti Senior Resident, Department of Paediatrics, Karawar Institute of Medical Sciences, Karwar.
Dr.Shivakumar N Hadli Assistant Professor, Department of General Surgery, Karawar Institute of Medical Sciences, Karwar
Dr. Laxminarayan Designation- Senior Resident, Department- Radiology, St. John's Medical College and Hospital, Bangalore

DOI:

https://doi.org/10.51168/j57gmj02

Keywords:

Expressed breast milk, microbial contamination, neonatal intensive care unit, preterm neonates, breast milk hygiene, hand hygiene, breast milk handling, Staphylococcus aureus, infection prevention

Abstract

Background:

Expressed breast milk (EBM) is regarded as the best nutritional source for premature and sick babies admitted to neonatal intensive care units (NICUs). Nevertheless, poor hygiene standards during expression, storage, transportation, and handling of the EBM can increase the risk of infection from bacteria in the milk.

Objectives:

1. To determine the prevalence of microbial contamination in expressed breast milk.

2. To identify the common microbial organisms isolated from expressed breast milk.

3. To assess maternal breast milk expression, storage, and transport practices.

4. To identify practices significantly associated with microbial contamination of expressed breast milk.

Methods:

A hospital-based cross-sectional study was done for 12 months on 178 mothers of LBW premature neonates who were admitted to a tertiary care NICU. Those mothers having breast infection, nipple bleeding, or systemic infection were excluded from the study. The EBM samples were checked for hygiene, expression, storage, and transportation. One mL was cultured on blood and MacConkey agar plates.

Results:

A cross-sectional study conducted in a hospital for 12 months included 178 mothers of LBW premature babies admitted to a tertiary care NICU. Mothers who had breast infection, nipple bleeding, or systemic infection were excluded from this study. The EBM samples were screened for hygiene, expression, storage, and transportation. One mL of the sample was inoculated on blood and MacConkey agar. The isolates were confirmed by the conventional method. The data were analyzed through SPSS 22.0.

Conclusion:

A high prevalence of EBM contamination was observed among mothers of preterm neonates. Maternal nail hygiene and appropriate handling of storage containers were significant determinants of contamination.

Recommendation

NICUs should strengthen standardized EBM expression, collection, storage, and transportation protocols. Mothers should receive regular education on hand hygiene, breast and equipment cleaning, safe storage, and timely milk delivery.

References

1. World Health Organization (WHO). Breastfeeding. 2018. https://www.who.int/health-topics/breastfeeding#tab=tab_1 WHO article. Accessed on 24 Jan 2023

2. World Health Organization (WHO). Breastfeeding. 2018. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. Accessed on 25jan 2023

3. World Health Organization (WHO). Breastfeeding. 2018. https://www.who.int/news-room/facts-in-pictures/detail/breastfeeding. Accessed 23 Jun 2023.

4. More than half of parents and pregnant women exposed to aggressive formula milk marketing-WHO, UNICEF, 2022. https://www.unicef.org/eap/press-releases/more-half-parents-and-pregnant-women-exposed-aggressive-formula-milk-marketing-who. Accessed 23 Jun 2023.

5. Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7:12. https://doi.org/10.1186/1746-4358-7-12

6. Zong X, Wu H, Zhao M, Magnussen CG, Xi B. Global prevalence of WHO infant feeding practices in 57 LMICs in 2010–2018 and time trends since 2000 for 44 LMICs. eClinicalMedicine. 2021;37:100971. https://doi.org/10.1016/j.eclinm.2021.100971

7. Heidi L. Hota, William R. Weinstein, Robert A. Weinstein, et al. Bacterial contamination of the hands of hospital staff during routine patient care: artificial nails as a potential reservoir. Infection Control & Hospital Epidemiology, 1999.

8. Boo, N. Y., Nordiah, A. J., Alfizah, H., Nor-Rohaini, A. H., & Lim, V. K. E. (2001).

9. Breast Hygiene Practices and the Microbial Quality of Expressed Breast Milk. Journal of Hospital Infection, 49(4), 274-281.

10. Ransome-Kuti, O., Oyewole, F., & Bamgboye, A. (1980). Effect of Maternal Breast Cleaning on the Microbial Content of Expressed Breast Milk. Journal of Tropical Pediatrics, 26(2), 82-85.

11. White, S. M., Hall, A. K., & Johnson, P. J. (2010). Comparison of Various Cleaning Methods for Breast Milk Storage Containers and Their Impact on Contamination Rates. Journal of Pediatric Health Care, 24(5), 309-315.