Being a pumping mom can already take a lot of time and dedication (not to mention, sometimes rude co-workers will moo at you). But after an infant got a serious infection and was left with destroyed brain tissue from a contaminated breast pump, health officials have developed new guidelines for cleaning and handling those tricky devices.
The Pennsylvania baby was born prematurely at about 29 weeks in April 2016, weighing three pounds. Despite being a preemie, her NICU care went relatively smoothly until she developed signs of sepsis at 21 days old. After having cultures and tests done, doctors determined she had Cronobacter sakazakii growing in her spinal fluid, an extremely rare infection that can be fatal for newborns and preemies. The Centers for Disease Control and Prevention only hears about four to six cases a year, nearly all of which have been associated with powdered infant formula.
Though the baby was treated with antibiotics, she suffered from seizures, severe meningitis and brain necrosis of the entire left cerebral hemisphere and right frontal lobe.
According to a CDC report released on Friday, the baby did not have powdered infant formula products but was fed both pasteurized donor milk and expressed maternal milk the first week, and fed then expressed maternal milk mixed with a commercial liquid human milk fortifier. Officials say the bacteria was found only in the breast pump used at home, the milk samples that were pumped at home and the kitchen sink's drain.
The mom would typically soak her pump parts in soapy water in a wash basin for hours, which could have been a breeding ground for germs, without scrubbing or sanitizing. She would then rinse, air-dry and store the kit in a plastic zip-top bag between uses.
"This case touched us very deeply and made us question whether women were getting the guidance they needed to pump their milk as safely as possible for their babies," Dr. Anna Bowen, CDC medical officer, told CBC News. "Breastfeeding is really one of the best things that a mother can do for her baby's health and development and we applaud mothers for pumping when the baby isn't able to directly breastfeed."
But Bowen says during the investigation, they barely found any guidance on how to pump breast milk safely. So the CDC developed its own guidelines in a two-page fact sheet.
Key steps include:
- Wash your hands with soap and water before handling pumps or pump kits. Clean the outside of your pump with disinfectant wipes.
- After pumping, immediately store pumped milk in a refrigerator, freezer or cooler bag
with ice packs.
- Take apart all pump parts that come into contact with your breast or breast milk. Rinse them under running water to remove remaining milk. Don't put them directly in the sink.
- Clean with hot water and soap as soon as possible in a separate wash basin or use a dishwasher. If using a dishwasher, run the dishwasher using hot water and a heated drying cycle
(or sanitizing setting). Wash your hands before taking out the parts.
- Allow parts to air dry thoroughly on an unused dish towel or paper towel, including the wash basin and bottle brush after they're cleaned. Do not rub or pat them dry with a towel.
- When they are completely dry, store items in a clean and protected area.
Some parents are applauding the CDC for finally providing official recommendations on how to keep breast milk sterile, especially for babies with already weakened immune systems.
But others are criticizing the new guidelines for fear-mongering and adding another thing for exhausted moms to worry about. Moms are already under enough stress trying to produce enough milk or keep up with frequent pumping breaks. Plus, what's a working mom in a not-pumping-friendly office with a communal sink supposed to do?