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

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

Folia Medica Indonesiana ◽

10.20473/fmi.v55i1.12552 ◽

2019 ◽

Vol 55 (1) ◽

pp. 30

Author(s):

Nur Aisyah Widjaja ◽

Kartika Hardiyani ◽

Meta Herdiana Hanindita ◽

Roedi Irawan

Keyword(s):

Breast Milk ◽

Room Temperature ◽

Culture Media ◽

Bacterial Species ◽

Microbiological Quality ◽

Coagulase Negative Staphylococcus ◽

Chi Square ◽

Tropical Country ◽

Expressed Breast Milk ◽

Term Baby

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 (30-36oC) for more than two hour reduce the quality and do not recommended to be given to the infants.

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

Folia Medica Indonesiana ◽

10.20473/fmi.v56i1.18447 ◽

2020 ◽

Vol 56 (1) ◽

pp. 24

Author(s):

Kartika Hardiani ◽

Nur Aisiyah Widjaja ◽

Meta Herdiana Hanindita ◽

Roedi Irawan ◽

Eddy Bagus Wasito

Keyword(s):

Breast Milk ◽

Klebsiella Pneumoniae ◽

Room Temperature ◽

Culture Media ◽

Bacterial Species ◽

Coagulase Negative Staphylococcus ◽

Streptococcus Faecalis ◽

Bacterial Colony ◽

Significant Difference ◽

Expressed Breast Milk

Expressed breast milk (EBM) has been advocated as an effective way for encouraging and maintaining lactation when the mother is separated from the baby for a while. Storing EBM at room temperature in several hours before consuming, frequently found in Indonesia. Based on WHO guidelines EBM can last for 6 to 8 hours in room temperature. But currently there hasn’t been study in tropical country especially Indonesia for the guidelines. Assesing 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. EBM were collected by electric breast pump swing model. The samples were kept sterile and laid at plates for 2 hours, 4 hours and 6 hours in room temperature (26o- 32oC) 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. There were strong correlation between 2 hours storing with 4 hours storing (p=0.004) and total colony (p=0.000). There were also significant difference between bacterial colony and the duration itself (p=0.026). 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. Evaluation result that 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 because bacterial counts > 104 cfu/ml and the present of pathogens E. coli, Streptococcus faecalis and Klebsiella pneumoniae.

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Bacterial load in expressed and stored breast milk of lactating mothers in Abia state, Nigeria

African Journal of Food, Agriculture, Nutrition and Development ◽

10.18697/ajfand.59.12640 ◽

2013 ◽

Vol 13 (59) ◽

pp. 8139-8154

Author(s):

PO Ukegbu ◽

◽

AC Uwaegbute ◽

II Ijeh ◽

AU Ukegbu ◽

...

Keyword(s):

Breast Milk ◽

Room Temperature ◽

Culture Media ◽

Bacterial Load ◽

Storage Conditions ◽

Milk Samples ◽

Lactating Mothers ◽

Expressed Breast Milk ◽

Time Periods ◽

Considerable Period

The use of expressed breast milk has been advocated as an effective way of encouraging and maintaining lactation when the mother is separated from the baby for a while. However, prospects of storage of expressed breast milk for any considerable period of time is hindered by the possibility of bacterial contamination and growth of infectious pathogens in the stored milk. Previous research worldwide has focused on optimal conditions for storing expressed breast milk. This study investigated bacterial growth in expressed breast milk stored at two different conditions and time periods. A total of 240 randomly selected lactating mothers participated in a survey used to elicit information on their practices concerning expressed and stored breast milk. Out of this, 20 lactating mothers were willing to donate their breast milk , which was used for microbial studies. Using antiseptic procedures, breast milk samples were collected from these 20 lactating mothers by manual expression and put into sterile containers. One half was stored at room temperature (30 o C), while the other half was immersed in a container of water (26 o C) for 0, 3, 6 and 9hrs. The samples at different time periods in both storage conditions were plated on three different culture media (Nutrient agar , MacConkey agar and Chocolate agar) and incubated for 24hrs. Bacterial load was enumerated and isolates were characterized and identified. Data was analyzed using one way ANOVA and presented as frequencies, percentages means and standard deviations. Results showed that in all the culture media, bacteria l load was higher in breast milk samples stored at room temperature for up to 9hrs compared to that immersed in water (p<0 .05). However, the average colony counts were within acceptable limits (<10 4 CFU/ml). Enterococcus faecalis , Escherichia coli and Staphylococcus aureus were the predominant bacteria isolated in the breast milk samples under both storage conditions. The findings from this study revealed that storage of breast milk either at room temperature or immersed in a container of water appeared to be safe for up to 9 hours of storage in a tropical environment . Generally, the number of microbes was within levels considered acceptable in expressed breast milk .

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Comparing Neonatal Pain Responses to Intravenous and Intramuscular Injections and Effect of Non- Pharmacological Measures

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i01/1031 ◽

2021 ◽

Vol 6 (01) ◽

pp. 30-37

Author(s):

Dr. Pearl Mary Varughese ◽

Dr. Nandita Pai ◽

Dr. Prakash M.

Keyword(s):

Breast Milk ◽

Demographic Data ◽

Chi Square ◽

Neonatal Pain ◽

Nutritive Sucking ◽

Expressed Breast Milk ◽

Qualitative Variables ◽

Birth Dose ◽

Group 3 ◽

Pain Responses

Background: Neonatal pain responses have been ignored for long, in spite of many pharmacological and non- pharmacological proven methods. Non pharmacological measures like breast feeding, non- nutritive sucking or glucose solutions are easily available, affordable and readily acceptable methods. Methods: 190 babies were compared for their responses to both intravenous pre discharge blood sampling and birth dose of hepatitis B vaccine. They were randomly divided into three groups - expressed breast milk (64 babies), 2ml 10% dextrose solution via syringe (63 babies), and non- nutritive sucking with 25% dextrose (63 babies). The response to each procedure was recorded in terms of cry duration and using NIPS scale. Kruskal Wallis test, Wilcoxon Signed Ranks test, Mann Whitney U test, ANOVA were used find the association between quantitative variables whereas McNemar test, McNemar-Bowker test and Chi-square test were used for qualitative variables. Results: The baseline demographic data of all the groups were comparable. The NIPS scores were reduced significantly in all the 3 groups in both the procedures. Babies on non-nutritive sucking with dextrose had the least scores, followed by babies on dextrose and finally those on expressed breast milk for both the procedures. All the 3 groups had significant variations in HR and SPO2 from baseline and at 3rd min, the variations were reducing with group 3 showing the maximum potential for quick stabilisation in both the procedures. The cry duration was significantly lower in group 3 in both the invasive procedures. Conclusion: Neonatal pain responses were least among the neonates provided with non- nutritive sucking with 25% dextrose during the intra-venous procedure and intra-muscular procedure. Non- nutritive sucking with 25% dextrose can be recommended as effective, reliable and useful method for decreasing the pain responses during the procedures.

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Galacto- and Fructo-oligosaccharides Utilized for Growth by Cocultures of Bifidobacterial Species Characteristic of the Infant Gut

10.26686/wgtn.12585584.v1 ◽

2020 ◽

Author(s):

Ian Sims ◽

GW Tannock

Keyword(s):

Breast Milk ◽

Bacterial Species ◽

Bifidobacterium Longum ◽

Well Being ◽

Bifidobacterium Bifidum ◽

Child Rearing ◽

Potential Growth ◽

Human Infants ◽

Infant Diet ◽

Growth Substrates

Copyright © 2020 American Society for Microbiology. Bifidobacterial species are common inhabitants of the gut of human infants during the period when milk is a major component of the diet. Bifidobacterium breve, Bifidobacterium bifidum, Bifidobacterium longum subspecies longum, and B. longum subspecies infantis have been detected frequently in infant feces, but B. longum subsp. infantis may be disadvantaged numerically in the gut of infants in westernized countries. This may be due to the different durations of breast milk feeding in different countries. Supplementation of the infant diet or replacement of breast milk using formula feeds is common in Western countries. Formula milks often contain galacto- and/or fructo-oligosaccharides (GOS and FOS, respectively) as additives to augment the concentration of oligosaccharides in ruminant milks, but the ability of B. longum subsp. infantis to utilize these potential growth substrates when they are in competition with other bifidobacterial species is unknown. We compared the growth and oligosaccharide utilization of GOS and FOS by bifidobacterial species in pure culture and coculture. Short-chain GOS and FOS (degrees of polymerization [DP] 2 and 3) were favored growth substrates for strains of B. bifidum and B. longum subsp. longum, whereas both B. breve and B. longum subsp. infantis had the ability to utilize both short- and longer-chain GOS and FOS (DP 2 to 6). B. breve was nevertheless numerically dominant over B. longum subsp. infantis in cocultures. This was probably related to the slower use of GOS of DP 3 by B. longum subsp. infantis, indicating that the kinetics of substrate utilization is an important ecological factor in the assemblage of gut communities.IMPORTANCE The kinds of bacteria that form the collection of microbes (the microbiota) in the gut of human infants may influence health and well-being. Knowledge of how the composition of the infant diet influences the assemblage of the bacterial collection is therefore important because dietary interventions may offer opportunities to alter the microbiota with the aim of improving health. Bifidobacterium longum subspecies infantis is a well-known bacterial species, but under modern child-rearing conditions it may be disadvantaged in the gut. Modern formula milks often contain particular oligosaccharide additives that are generally considered to support bifidobacterial growth. However, studies of the ability of various bifidobacterial species to grow together in the presence of these oligosaccharides have not been conducted. These kinds of studies are essential for developing concepts of microbial ecology related to the influence of human nutrition on the development of the gut microbiota.

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Efficacy of sucrose verses expressed breast milk for pain among neonates receiving vaccination, in india

International Journal of Pharma and Bio Sciences ◽

10.22376/ijpbs.2017.8.2.b949-955 ◽

2017 ◽

Vol 8 (2) ◽

Author(s):

MRS. SUJATHA S ◽

DR. REBECCA SAMSON ◽

DR. BRIDGITTE AKILA ◽

DR. SUNDARE SAN

Keyword(s):

Breast Milk ◽

Expressed Breast Milk

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Antimicrobial Resistance among Neonates with Bacterial Sepsis and Their Clinical Outcomes in a Tertiary Hospital in Kathmandu Valley, Nepal

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6020056 ◽

2021 ◽

Vol 6 (2) ◽

pp. 56

Author(s):

Bijendra Raj Raghubanshi ◽

Karuna D. Sagili ◽

Wai Wai Han ◽

Henish Shakya ◽

Priyanka Shrestha ◽

...

Keyword(s):

Antibiotic Resistance ◽

Neonatal Sepsis ◽

Bacterial Culture ◽

Bacterial Species ◽

Antibiotic Sensitivity ◽

College Teaching ◽

Hospital Treatment ◽

Resistant Bacteria ◽

Coagulase Negative Staphylococcus ◽

Cross Sectional

Globally, antibiotic resistance in bacteria isolated from neonatal sepsis is increasing. In this cross-sectional study conducted at a medical college teaching hospital in Nepal, we assessed the antibiotic resistance levels in bacteria cultured from neonates with sepsis and their in-hospital treatment outcomes. We extracted data of neonates with sepsis admitted for in-patient care from June 2018 to December 2019 by reviewing hospital records of the neonatal intensive care unit and microbiology department. A total of 308 neonates with sepsis were admitted of which, blood bacterial culture antibiotic sensitivity reports were available for 298 neonates. Twenty neonates (7%) had bacteriologic culture-confirmed neonatal sepsis. The most common bacterial species isolated were Staphylococcus aureus (8), followed by coagulase-negative Staphylococcus (5). Most of these bacteria were resistant to at least one first-line antibiotic used to manage neonatal sepsis. Overall, there were 7 (2%) deaths among the 308 neonates (none of them from the bacterial culture-positive group), and 53 (17%) neonates had left the hospital against medical advice (LAMA). Improving hospital procedures to isolate bacteria in neonates with sepsis, undertaking measures to prevent the spread of antibiotic-resistant bacteria, and addressing LAMA’s reasons are urgently needed.

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Breastfeeding initiation among women with preeclampsia with and without severe features

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200508 ◽

2020 ◽

pp. 1-8

Author(s):

L. Cordero ◽

M.R. Stenger ◽

M.B. Landon ◽

C.A. Nankervis

Keyword(s):

Retrospective Study ◽

Breast Milk ◽

Hospital Stay ◽

Late Onset ◽

Preterm Births ◽

Severity Of Illness ◽

Premature Delivery ◽

Breastfeeding Initiation ◽

Expressed Breast Milk ◽

Timely Delivery

BACKGROUND: Timely delivery and magnesium sulfate (MgSO4) are mainstay in the treatment of preeclampsia with severe features (PWSF). Premature delivery, severity of illness and mother-infant separation may increase the risk for breastfeeding (BF) initiation failure. OBJECTIVE: To compare BF initiation among women with late-onset PWSF for women with late-onset preeclampsia without severe features (WOSF). METHODS: Retrospective study of 158 women with PWSF and 104 with WOSF who delivered at ≥34 weeks. Intention to BF, formula feed (FF) or partially BF was declared prenatally. At discharge, exclusive BF included direct BF or direct BF with expressed breast milk (EBM). RESULTS: PWSF and WOSF groups were similar in age, race, and obstetric history. PWSF and WSOF differed in primiparity (65 & 51%), late preterm births (73 vs 15%), admission to NICU (44 &17%) and mother (5 & 4d) and infant (6 & 3d) hospital stay. Both groups were similar in intention to BF (80 & 84%), to FF (16 & 13%) and to partially BF (5 & 5%). At discharge, exclusive BF (37 & 39%), partial BF (33 & 31%) and FF (30 & 30%) were similar. Exclusive BF in the PWSF group was 43% direct BF, 28% direct BF and EBM and 29% EBM alone whereas in the WOSF group exclusive BF was 93% direct BF and 7% direct BF and EBM. CONCLUSION: BF initiation rates for women with PWSF and WOSF were similar. EBM alone or with direct BF enabled infants in the PWSF group to exclusively BF at discharge.

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An Understanding of the Global Status of Major Bacterial Pathogens of Milk Concerning Bovine Mastitis: A Systematic Review and Meta-Analysis (Scientometrics)

Pathogens ◽

10.3390/pathogens10050545 ◽

2021 ◽

Vol 10 (5) ◽

pp. 545

Author(s):

Paramanandham Krishnamoorthy ◽

Kuralayanapalya P. Suresh ◽

Kavitha S. Jayamma ◽

Bibek R. Shome ◽

Sharanagouda S. Patil ◽

...

Keyword(s):

Escherichia Coli ◽

Management Practices ◽

Meta Analysis ◽

Bacterial Species ◽

Clinical Mastitis ◽

Therapeutic Interventions ◽

Coagulase Negative Staphylococcus ◽

Prevalence Studies ◽

The World ◽

Pathogen Prevalence

In this study, the major mastitis pathogen prevalence in the cattle and buffalo of the world was estimated by a meta-analysis. Staphylococcus (S) species, Streptococcus (St) species, and Escherichia coli (Ec) prevalence studies reported during 1979–2019 were collected using online databases, and offline resources. A meta-analysis of these data was done with the meta package in R-Software. The Staphylococcus aureus was the major mastitis pathogen, mostly causing subclinical mastitis, Ec causing clinical mastitis and St causing subclinical and clinical mastitis. The pooled prevalence estimates of S, St, and Ec were 28%, 12%, and 11% in the world from 156, 129, and 92 studies, respectively. The S, St, and Ec prevalences were high in Latin America (51%), Oceania (25%), and Oceania (28%), respectively. Higher S, St, and Ec prevalences were observed by molecular methods, signifying high sensitivity and usefulness for future studies. Among bacterial species, S. aureus (25%) followed by coagulase-negative Staphylococcus species (20%), Escherichia coli (11%), St. agalactiae (9%), St. uberis (9%) were the important pathogens present in the milk of the world. We hypothesize that there is a urgent need to reduce mastitis pathogen prevalence by ensuring scientific farm management practices, proper feeding, therapeutic interventions to augment profits in dairying, and improving animal and human health.

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