general characteristics
The study is carried out with the aim of selecting etiological therapy for postpartum mastitis in nursing mothers, confirming the sterility of milk used to feed newborns with dysbacteriosis. Normally, breast milk may contain saprophytic microorganisms from the environment: Enterococcus spp, Staphylococcus epidermidis in small quantities. The detection of Staphylococcus aureus, Pseudomonas aeruginosa, microorganisms of the Enterobacteriaceae family, and yeast-like fungi of the genus Candida in milk indicates the presence of an inflammatory process. Isolated microorganisms: Streptococcus pyogenes, Staphylococcus aureus, Streptococcus spp., Coagulase-negative staphylococci, Enterobacteriaceae, Pseudomonas aeruginosa, Candida spp.
How and why bacteria get into breast milk
There are three ways that Staphylococcus aureus gets into breast milk:
- Airborne path. It is the most common route of penetration of staphylococcus in maternity hospitals. It is in medical institutions that it is the most antibiotic-resistant, so it is most difficult to “defeat” it. This is why it is so important to regularly carry out disinfection measures.
- Contact. It can be done by touching the skin of the breasts and nipples, especially if they have cracks. Injured nipples are a favorable place for the proliferation of staphylococcus, as it is humid and warm there.
- Intrauterine. If a woman does not take care of her dental health during pregnancy and suffers from frequent sore throats and dysbacteriosis, then the child has a high risk of being infected with Staphylococcus aureus from the mother.
Patient preparation rules
Standard conditions:
Before expressing, hands and mammary glands are treated with soap, nipples and the area around the nipple with 70% alcohol (each gland is treated with a separate tampon).
The initial portion (5 - 10 ml) is not used for analysis; it is decanted into a separate container and poured out. Collect milk from each gland in a separate sterile container in the amount of 4-5 ml. The material is accepted in the first department of ML "DILA" "ML "Dila" at the address: st. Podvysotsky, 6A. During the working day ML "DILA". Deliver the material after collection within 2 hours at a temperature of +4...+8°C. Important
: A separate sterile container is used for the material from each breast.
You can add this study to your cart on this page
Diagnosis of presence by taking an analysis
In order to determine the number of staphylococci in breast milk, it must be collected and sent to the laboratory. To do this, it is necessary to correctly collect milk for research.
- Take disposable sterile containers (from the pharmacy) or glass jars, pre-boiled with lids for 20 minutes. There should be 2 containers, separately for each breast, with a mandatory mark on each jar.
- Wash your hands and breasts with warm water and soap before pumping.
- Express the first 5 - 10 ml of milk separately, as it is not suitable for research. Then express 5 - 10 ml of milk from each breast into an appropriate container and close the lids tightly.
- Deliver the milk to the laboratory, where it is sown on a special nutrient medium.
Video Doctor Komarovsky about the analysis for Staphylococcus aureus
After 5-7 days, colonies of microorganisms grow on the nutrient medium. After this, microbes are identified and their quantity determined.
Important! To determine the concentration of Staphylococcus aureus in breast milk, the milk must be properly collected and sent to the laboratory within 3 hours.
There are only approximate standards for the amount of Staphylococcus aureus in milk, since it cannot be completely sterile. This microorganism can get there from a woman’s hands, from the air, or from clothing.
- The growth of 50 - 100 colonies of staphylococcus is the norm.
- More than 100 colonies – pathology.
Where does staphylococcus come from?
Staphylococci are bacteria that cause a wide variety of diseases. In small quantities they usually have no effect on the body. But under favorable conditions their concentration increases. As a result, consequences such as abdominal pain, digestive disorders, sore throat, otitis media, pneumonia and other diseases are possible.
Staphylococcus aureus is especially dangerous. The bacterium has a golden color, for which it was given its name. It is in a microcapsule, thanks to which it easily penetrates into tissues. In a certain environment, it produces toxic substances and enzymes that have a destructive effect on cells. Immunity to staphylococcus is not developed, so repeated infections cannot be ruled out in the future.
If staphylococcus is found in breast milk, this means that the woman is a carrier of the bacteria. She could have become infected in one of the following ways.
- Airborne. Often such infection occurs in hospitals, including maternity hospitals. It is quite difficult to fight bacteria brought from medical institutions, as they become resistant to antibiotics. To prevent their spread, these establishments must be properly sanitized.
- Contact. The pathogen can be found on common objects, on stair railings, on handrails in vehicles and in other places. Therefore, you should wash your hands with soap on time.
Signs of staphylococcus in breast milk
Staphylococcus enters breast milk from the skin. The risk is especially high for cracks in the nipples, even microscopic ones, which do not cause pain. A small amount of bacteria will not affect the baby’s body. But under certain conditions the risk of developing diseases increases:
- if immunity is reduced, for example due to a cold;
- if the child was born premature, does not gain weight well;
- if the baby is on mixed feeding.
To determine whether an infection has actually occurred, a breast milk test for staphylococcus is needed. There is no point in taking it prophylactically only if the condition of the child or his mother causes concern.
We list the possible symptoms of the development of staphylococcal infection.
- Enterocolitis. The baby is restless because his tummy hurts. The stool is loose, frequent, and may contain mucus. All this is often accompanied by vomiting and fever.
- Pemphigus. The child’s skin is affected, and rashes appear on them that resemble blisters with liquid.
- Conjunctivitis. One of the most common signs of staphylococcus in breast milk. The child's eyes become red and watery, purulent discharge begins, and the eyelids stick together.
- Abscesses. The baby develops ulcers on his body, the skin around them is reddish. The toddler becomes lethargic and the temperature may rise. An abscess can also develop in a mother's breast affected by bacteria. This is a gradual process, it begins with lactostasis, turning into mastitis. It can be avoided if, during stagnation, you put the baby to the breast more often.
If any of these signs appear, you should take your child to the doctor. He will prescribe the necessary tests and subsequently treatment.
Is breastfeeding possible?
Although staphylococcus can cause serious illness, its presence in breast milk does not always require cessation of breastfeeding. In fact, such a need arises quite rarely. And it should not be the presence of bacteria itself that causes it, but the state of health of the child and mother. If the baby feels great, the mother does not have any inflammatory processes, then a small amount of bacteria should not be scary.
You need to know that initially beneficial bacteria from the intestines enter milk, which help normalize the baby’s microflora. If a pathogen was detected, it got into the milk from the skin. Even if it moves into the child’s intestines, this does not mean that there will be any consequences. After all, breast milk contains many special substances that protect the baby from infections.
Prevention
A nursing mother needs to eat a balanced diet, shower regularly, keep her linen clean, and also wear a special bra for nursing women. If there are cracks in the nipples, you need to treat them in time, lubricate them with Bepanten ointment and leave the breasts for a few minutes for air baths.
The detection of Staphylococcus aureus in breast milk is not a pathology. The alarm should be sounded when the number of microorganisms exceeds 100 colonies grown on a Petri dish. The condition of the nursing mother and baby should also be taken into account. There is no need to self-medicate or refuse doctor’s recommendations, as the consequences can be dangerous.
Staphylococcus test
To determine the presence of staphylococcus in breast milk, you need to get tested. They do it this way. First, prepare the container: sterilize two jars and wipe them with a clean cloth. Then they begin to express. The first milk is poured out, then about 10 ml is collected.
Advice
To avoid cracked nipples, you can lubricate your breasts with an oil solution of vitamins A and E. The skin will be more elastic and less prone to injury, which means that staphylococcus will not get into the milk.
It is worth paying attention that each breast is expressed into a separate jar. Liquids must not be mixed. The shelf life of the material is up to three hours, during which time it should be delivered to the laboratory. To prescribe treatment, the concentration of bacteria and their sensitivity to certain drugs will be determined.
Unfortunately, this research is not always informative; the result may be incorrect. After all, it is impossible to make a container completely sterile. If the analysis showed the presence of Staphylococcus epidermidis in breast milk, then the material was probably collected incorrectly. But Staphylococcus aureus in milk usually means infection with bacteria.
A baby may also need treatment. Then a stool microflora analysis will be prescribed. For reliability, the study is carried out several times with an interval of two days.
Treatment of staphylococcal infection and its consequences
If mastitis in a nursing woman does not become purulent, then treatment can be carried out with folk remedies. For example, apply a scalded cabbage leaf to your chest or make a compress with a saline solution - dissolve 1 tablespoon of salt in a glass of warm water. If a woman is unable to cope with mastitis, it can turn purulent.
If purulent mastitis is detected in a nursing woman, it is imperative to consult a doctor and undergo appropriate treatment, including antibiotics. The doctor will select a drug that will be as safe as possible for the child. If a nursing woman does not take antibiotics, this can lead to fistulas, breast deformation, and sepsis. When it is impossible to select an antibiotic that would not have a significant effect on the child’s health, breastfeeding is stopped.
Important! Each treatment situation is completely individual. It is necessary to focus on the condition of the nursing mother herself and the condition of the child, and take into account the doctor’s recommendations.
What treatment may be needed
In some situations, treatment cannot be avoided.
- Staphylococcal mastitis. WHO does not recommend interrupting breastfeeding; therapy includes increasing the number of times the baby is put to the breast. For this disease you need to take antibiotics. The doctor selects those that can be combined with lactation.
- Manifestation of staphylococcal infection in infants. A decision must be made on an individual basis. If there is a high titer of bacteria in the milk, then temporary weaning is possible. But you should not just cure the baby, but figure out why his immunity is reduced.
Doctors may prescribe the following:
- probiotics to normalize microflora;
- to destroy pathogenic bacteria, herbal antiseptics with bacteriophages are recommended, such as “Chlorophyllipt” and “Rotokon” (the course of treatment is up to two weeks);
- The same means, which are not dangerous for the child, are used to treat the breasts, as there may be cracks on them.
To normalize the condition of mother and child, you need to simultaneously act in different directions:
- use antibiotics to suppress the infection;
- strengthen the body's protective properties;
- tidy up your hormonal levels and metabolism.
