A detailed explanation of breast milk culture for sterility (for microflora): why is this analysis needed and can its results be trusted? How to test breast milk Where can I donate breast milk for analysis

It used to be thought that breast milk was absolutely sterile, but numerous studies have proven that this is not entirely true. Milk can still contain various microorganisms. Basically, these are representatives of conditionally pathogenic microflora, which most often quietly exist on the skin, mucous membranes, in the intestines and do not cause any harm. However, under certain conditions (decreased immunity, chronic diseases, general weakness of the body after an infectious disease, intestinal dysbacteriosis), they begin to multiply rapidly, causing various diseases.
The main bacteria that can live in breast milk are: staphylococci (epidermal and aureus), enterobacteria, Klebsiella, fungi of the genus Candida.
The most dangerous of this company is Staphylococcus aureus. It is he who, having penetrated into the mammary gland, can cause purulent mastitis in a nursing mother. And once in the baby's body along with breast milk, staphylococcus aureus can cause diseases such as:

• enterocolitis (frequent, loose, watery stools, abdominal pain, fever, frequent regurgitation, vomiting);
• purulent inflammation on the skin;
• the phenomena of intestinal dysbacteriosis (accelerated stools, excessive gas formation, accompanied by bloating and discharge of a large amount of gases during defecation, frequent regurgitation, the appearance of undigested lumps in the feces, a change in the color of feces - yellow-green, the color of marsh mud). Staphylococcus aureus is protected from the outside by a capsule that helps it penetrate organs and tissues without being destroyed. After the invasion, it begins to release toxic substances that have a destructive effect on the structure of cells. This type of staphylococcus is very resistant to various external factors, and it can be very difficult to “expel” it from the body. Other microorganisms, having settled in breast milk, can also cause a lot of trouble.
• Mushrooms of the genus Candida, hemolyzing Escherichia coli and Klebsiella, which penetrate the baby with breast milk, are able to ferment glucose, sucrose and lactose, while forming a large amount of gas. This, in turn, causes pain, bloating and diarrhea in the child.

How do microbes get into milk?

Microorganisms enter breast milk mainly through the skin. This can happen if the baby is incorrectly applied to the breast, the breast is incorrectly removed from his mouth, and mistakes are made when caring for the mammary glands. In such cases, microtraumas and cracks in the nipples may appear, which are the entrance gate for the infection to enter the mammary glands and, accordingly, into breast milk.
Who "lives" in milk?
You can find out which microbes live in breast milk and in what quantity by doing a special study, the so-called sowing milk.

It allows you to detect various pathogens in it, determine their number and, if necessary, determine sensitivity to antibacterial drugs.
It is not at all necessary for all lactating women to take milk for analysis to find out if it is dangerous for the baby. Such a study should be carried out only in cases where there is a suspicion of infectious diseases in the baby or inflammatory diseases of the mammary gland in the mother.
In what cases is it necessary to hand over milk for analysis? The indications will be as follows.
From the side of the child:

• recurring purulent-inflammatory diseases of the skin;
• dysbacteriosis;
• prolonged diarrhea (frequent loose stools) with greens and mucus.

From mom's side:

• signs of mastitis (inflammation of the mammary gland) - chest pain, fever, redness of the skin of the mammary gland, purulent discharge from it.

How to collect milk for analysis?

When collecting breast milk for analysis, it is important to understand that it is necessary to try to exclude the possibility of bacteria from the skin entering the milk. Otherwise, the result of the study may be unreliable. There are certain rules for collecting breast milk for sowing.

1. First of all, you need to prepare a container for expressed milk. These can be sterile disposable plastic cups (you can buy them at a pharmacy) or clean glass jars that must first be boiled with a lid for 15–20 minutes.
2. There should be two containers for expressed milk, as the milk for analysis from each breast is collected separately. Containers should be labeled from which breast the milk was taken.
3. Before pumping, wash your hands and chest with warm water and soap.
4. The first 5–10 ml of expressed milk is not suitable for testing and should be discarded. After that, the required amount of breast milk (5–10 ml from each mammary gland is required for analysis) must be expressed into prepared sterile containers and tightly closed with lids.

In the laboratory, milk is sown on a special nutrient medium. After about 5-7 days, colonies of various microbes grow on it. Next, it is determined to which group of pathogens these microorganisms belong, and their number is counted.

Should I breastfeed with mastitis?

If germs are present in breast milk, a breastfeeding mother should consult a doctor. Only he can decide whether treatment is necessary or not. The World Health Organization (WHO) believes that the detection of bacteria in breast milk is not a reason to stop breastfeeding. The fact is that all pathogens, penetrating the body of a nursing mother, stimulate the production of special protective proteins - antibodies that get to the baby during feeding and protect him. That is, if some microorganisms are found in the milk, but there are no signs of disease (purulent mastitis), breastfeeding will be safe, since the child receives protection from infections along with milk.

If staphylococcus is found in breast milk, treatment with antibacterial drugs is prescribed only in case of purulent mastitis in the mother, when she has signs of infection. At the same time, doctors recommend temporarily (for the duration of the mother's treatment with antibiotics) not to put the baby to the diseased breast, to regularly express milk from it, but to continue to feed him from a healthy mammary gland.

In cases where the symptoms of a staphylococcal infection are found in both the mother and the child, the mother and baby are treated simultaneously. At the same time, this disease can manifest itself in a child in different ways:

• inflammation of the mucous membrane of the eyes (at the same time, the eyelids swell and the eyes fester);
• inflammation of the area around the navel (the skin in this place swells, turns red and pus is released from the umbilical wound);
• purulent-inflammatory skin lesions (bubbles of various sizes appear on the baby's skin, filled with purulent contents, and the skin around them turns red);
• inflammation of the small and large intestines (in this case, abundant watery stools appear up to 8-10 times a day, maybe with an admixture of mucus and blood, vomiting, abdominal pain).

To confirm the diagnosis and determine the pathogen, the doctor may prescribe a culture of the inflammation separated from the focus (eyes, umbilical wound, the contents of the vesicles on the skin). And in case of violation of the intestines in the baby, a fecal analysis for the microflora is prescribed.

How to keep milk "clean"

In order for the milk to remain “pure” and it was not necessary to interrupt breastfeeding, depriving the baby of the best food for him, a nursing mother can be advised to follow a diet with a restriction of sweet, starchy and rich foods, as their abundance creates a favorable environment for the reproduction and growth of microbes.
It is also important to prevent the formation of cracked nipples. And for this you need to properly attach the baby to the breast (at the same time, the baby captures most of the areola, and not just the nipple, its lower lip is turned outward, and the nose touches the chest) and follow a few rules when caring for the mammary glands (wash the breast no more than 1– 2 times a day; arrange air baths for the nipples after feeding and between them; lubricate the nipples after feeding with drops of "hind" milk released at the end of feeding, as it has protective and healing properties and protects the nipple from dryness; do not apply to treat the nipple and areola, various disinfectants - brilliant green, alcohol, etc., as this contributes to the drying of the skin of the nipple and areola, followed by cracking).
If cracks nevertheless appear, then it is necessary to treat them in a timely manner in order to prevent infection and the development of mastitis.

Should I be treated if nothing hurts?

When staphylococcus aureus is present in breast milk, but there are no signs of infection in a nursing woman, breastfeeding is not stopped, but at the same time, as a rule, the mother is prescribed treatment (orally and locally) with drugs from the group of antiseptics that are not contraindicated in breastfeeding, and the child is given a doctor prescribe probiotics (bifido- and lactobacilli) for the prevention of dysbacteriosis.

Many women think that if there are no signs of a disease, then treatment can not be carried out. However, this opinion cannot be considered correct. The problem is that in such a situation, the mother’s condition will not worsen, but the baby can be harmed. If a child is fed infected milk for a long time, then the composition of bacteria in his intestines may be disturbed and the body's defenses will fail. Therefore, the mother must be treated without interrupting breastfeeding.

We evaluate the result of the analysis of breast milk

What can be seen on the analysis form that comes from the laboratory?

• Option 1. When sowing milk, no growth of microflora is observed, i.e. milk is sterile. It should be noted that this result of the analysis is very rare.
• Option 2. When sowing milk, the number of non-pathogenic microorganisms (epidermal staphylococcus aureus, enterococci) increased insignificantly. These bacteria are representatives of the normal microflora of the mucous membranes and skin and do not pose a danger.
• Option 3. When sowing milk, pathogens were found (Staphylococcus aureus, Klebsiella, hemolyzing Escherichia coli, fungi of the genus Candida, Pseudomonas aeruginosa). Their allowable content in breast milk is no more than 250 colonies of bacteria per 1 ml of milk (CFU / ml).

Currently, most mothers are striving for full breastfeeding. After all, it is known that breast milk, fully provides the baby with all the nutritional components necessary for full growth (proteins, fats, carbohydrates, minerals and vitamins), because it contains them in the required quantities and in the correct proportions. In addition, mother's milk contains special biologically active substances, the so-called protective factors that support the immunity of the child's body. The infant's own mechanisms to prevent infection are immature, and colostrum and breast milk due to its composition, they protect the intestinal mucosa from inflammation, inhibiting the growth of pathogens, and also stimulate the maturation of intestinal cells and the production of factors of their own immune defense. The highest concentration of protective factors is noted in colostrum, in mature milk it decreases, but at the same time the volume of milk increases, and, as a result, the child receives protection from many diseases constantly, throughout the entire period of breastfeeding. The longer breastfeeding, the more protected the baby from diseases. However, if the mother has an infectious disease, the question of whether to continue breastfeeding or not is decided together with the attending pediatrician. In the case of acute purulent mastitis, breastfeeding is stopped (most often for the duration of antibiotic treatment, up to 7 days). For other forms of mastitis (not purulent), experts recommend continuing breastfeeding. This will quickly eliminate the stagnation of milk. Very often, to identify pathogens, sick nursing mothers are asked to take breast milk for analysis, which determines the microbiological sterility of milk, after which the issue of breastfeeding is decided. The study is carried out in the bacteriological laboratories of the SES or medical institutions, information about which is available from the local pediatrician. How justified are such studies? According to the World Health Organization, each pathogenic microbe that infects a nursing mother stimulates the production of special protective proteins - antibodies that enter the breast milk and protecting babies both full-term and premature. Scientists have identified antibacterial and antiviral factors found in breast milk that can resist most infections. researched breast milk and feces of babies, this is milk consuming. It turned out that in most cases the microorganisms found in milk, in the feces child missing. This suggests that microbes that can cause diseases, getting into the baby's intestines with milk, most often do not take root there, which is facilitated by the protective properties of breast milk. Thus, even if some microorganisms are found in the milk, but there are no signs of acute purulent mastitis, breastfeeding will be safe, because the baby also receives protection from diseases with milk. Moreover, in this case, there is even no need to take an analysis of milk for sterility. It's just that in district clinics, when recommending this analysis, they often simply follow tradition.

Infection or normal?

In breast milk, not only pathogenic microbes can be found, but also representatives of the normal microflora of the skin and mucous membranes - epidermal staphylococci and enterococci, which perform a protective function. The presence in the analysis of representatives of normal microflora only indicates that the milk for analysis was collected incorrectly. Therefore, if their number is above the norm, it is impossible to draw any categorical conclusions. Pathogenic microbes include Staphylococcus aureus, hemolyzing Escherichia coli, Klebsiella, etc. The ways of infection transmission are different. Firstly, dangerous microbes can enter the milk during an infectious disease of the mother (for example, with tonsillitis), as well as with acute purulent mastitis. Secondly, during pumping and storage, when the pump or container is not clean enough. Fortunately, most often, microorganisms of the normal flora of the mother's skin get into the expressed milk. Normally, 1 ml of milk can contain no more than 250 bacterial colonies (250 CFU/ml). This number is a kind of boundary between the norm and the dangerous state. If it is less, pathogenic microbes do not pose a danger to the baby. But with a weakened immune system, for example, in very premature babies, a much smaller number of pathogens can also be dangerous. The decision to continue breastfeeding in such cases is made depending on the condition child. At the present stage of development of medicine, breast milk tests for sterility are no longer very relevant, because a doctor can diagnose "purulent mastitis" without analysis results. And yet, in some cases, the study of milk is absolutely necessary. Bacteriological examination is mandatory:

• if a woman has been ill with purulent mastitis;
• if child the first 2 months of life there is persistent diarrhea (liquid dark green stool mixed with a large amount of mucus and blood), which is combined with a low weight gain.

Breastfeeding is the natural process of feeding a newborn baby. It is mother's milk that is for a child that magical cocktail that contains everything necessary for normal growth and development, because the composition of breast milk consists of vitamins and trace elements, nutrients, hormones, enzymes, immunoglobulins, and so on. Therefore, mother's milk for a baby is both drink, and food, and medicine, and a sedative, and close communication with the person closest to him. As a rule, breastfed babies gain weight better, grow up healthier and more resistant to various infections and viruses.

But it happens that a child is naughty for a long time, sleeps and eats poorly, gains little or no weight, suffers from disorders of the gastrointestinal tract. Then the mother, trying to understand the cause of her baby's malaise, comes to the conclusion that something is wrong with her milk. And to dot the "i" will help the analysis of breast milk.

When do you really need to take an analysis, how to decipher it and how useful is it for a nursing mother? All these questions have become quite relevant in recent times.

Breast milk analysis: what is it and how to donate it

Breast milk analysis is a study of mother's milk in the laboratory for the presence of pathogenic microorganisms that can harm both the mother (the development of mastitis) and the baby.

For analysis, you need to collect a small amount of milk - 10-15 ml from each breast in separate sterile containers. Before expressing milk, hands and breasts should be washed well with soap and dried with a sterile cloth. The first 5 ml of the expressed liquid should be poured out and only the next portion should be collected in a jar or test tube. Each bowl indicates which breast this milk was collected from - the right or the left, as the result may differ. The containers with the collected material should be taken to the laboratory after two to three hours.

In the laboratory, each sample is placed in a special nutrient medium for 3-5 days. During this time, colonies of various microbes form in them, the number of which directly affects the result. The laboratory assistant counts their number, checks resistance to various antibiotics and bacteriophages. Having received the result from the laboratory, the doctor deciphers the analysis and, if necessary, selects the treatment for both the nursing mother and the nursing baby.

Decryption

The form of the result of the analysis of breast milk is provided in the form of a table with a list of different microbes, opposite which their number and degree of resistance to drugs are indicated.

Normally, the skin of every healthy mother is inhabited by microorganisms. Of all the existing diversity, three large groups can be distinguished: harmless, conditionally pathogenic and pathogenic. The first includes enterococci and epidermal staphylococci. Streptococci are conditionally pathogenic. Among all representatives of pathogenic microflora, special attention is paid to the following:

• golden staphylococcus aureus;
• Pseudomonas aeruginosa;
• coli;
• klebsiella;
• mushroom Candida.

Staphylococcus aureus is the most dangerous of this list. It provokes disorders of the gastrointestinal tract (which is accompanied by vomiting, diarrhea, abdominal pain), affects the skin (pustules and boils, purulent mastitis) and mucous membranes (angina, pleurisy, otitis and sinusitis develop).

Pseudomonas aeruginosa, Escherichia coli, Klebsiella and Candida mushrooms also bring a lot of trouble to the quiet life of mother and baby. All these microbes have the ability to ferment lactose, fructose, sucrose, resulting in a huge amount of gas. Therefore, the owners of such pathogenic flora suffer from colic and abdominal pain.

As you can see, these pathogens can cause high fever, discomfort and soreness in the chest, upset of the gastrointestinal tract, inflammation of the skin and mucous membranes. Often, the baby's malaise is accompanied by refusal of the breast, capriciousness, and poor sleep.

If all or most of the above symptoms are complemented by a high number of microbial colonies (over 250 IU / ml), then treatment should be carried out without fail without weaning from breastfeeding. During this difficult period, mother's milk contains special antibodies to fight infection, so it is easier for the child to cope with the disease. An exception when it is impossible to continue breastfeeding is purulent mastitis in the mother.

As a rule, children in case of damage by pathogenic microbes (Staphylococcus aureus is especially common) are prescribed a course of bifidus or lactobacilli. Recently, in the fight against harmful microorganisms, doctors often use bacteriophages and plant antiseptics. If there is a need for antibiotic treatment, then those drugs that are compatible with breastfeeding are selected, because mother's milk contains protective substances - immunoglobulins and antibodies. Therefore, even in the event of an attack by pathogenic microbes, breast milk does more good than harm.

Summarize

Based on the foregoing, the analysis of breast milk is not mandatory. Although such a study has become quite popular among nursing mothers, it should be done only if:

• breast problems (with the development of mastitis) in a nursing woman;
• a long-term disorder of the gastrointestinal tract in a baby (diarrhea mixed with mucus and / or blood, dark green feces);
• no weight gain or weight loss.

If everything is in order with the nursing mother and the baby (both are healthy, in excellent mood and well-being), then the analysis of breast milk is inappropriate and is only a reason for the mother to worry.

The result of the analysis of breast milk shows which microbes are present in it, in what quantity, and how resistant they are to drugs. Decoding is done by doctors, and, if necessary, based on the results of the analysis, optimal treatment is prescribed.

It is best, of course, not to allow a situation where the analysis of breast milk becomes necessary. To do this, a nursing mother needs to remember about proper nutrition, not to abuse sweet, floury and rich, to observe hygiene, if possible, lubricate the nipples and the areola area with an oil solution (vitamins A and E) to avoid cracks in which pathogenic microbes multiply rapidly.

And the most important thing is not to stop breastfeeding, because mother's milk is the best medicine for a baby under any circumstances.

Especially for - Valentina Berezhnaya

Content:

When can the presence of microbes in milk be a sign of illness?

The presence of various microbes in breast milk should be considered a sign of illness only if the woman who passed the test has other signs of infection (mastitis): fever, severe chest pain, redness and inflammation of the breast. In all other cases, the determination of microbes in milk should not be carried out, and if it was carried out and revealed the presence of microbes in breast milk, it should be considered a completely normal phenomenon.

What should I do if staphylococci or other microbes are found in my breast milk? Should breastfeeding be interrupted?

Under no circumstances should breastfeeding be interrupted if microbes are found in breast milk! In the body of healthy women, the development of these microbes is inhibited by the work of the immune system, which produces special factors that inhibit the development of microbes. These factors (for example, IgA antibodies) are present in the milk itself. Consequently, children who drink mother's milk, along with milk, also acquire protection against these microbes.

Boiling breast milk in order to destroy the microbes present in it is also impossible. Mother's milk is a unique living product that loses most of its beneficial properties when boiled.

What is the treatment for the presence of staphylococcus or other microbes in breast milk?

In the case of healthy women without any signs of mastitis, it is completely useless and even dangerous to treat if any numbers of microbes are found in breast milk.

Treatment of children is also not necessary.

If a child has any symptoms that are allegedly associated with his "infection through mother's milk" - this theory should be completely rejected and the true causes of the disease should be found.

Sterile milk is the ideal food for a newborn. But even in such food, harmful bacteria and infections sometimes get into it. Some bacteria are safe and will not harm the baby and mother, especially if the nursing woman has strong immunity. Antibodies block harmful substances and stop reproduction.

However, after childbirth, a woman loses many useful vitamins and elements, the immune system weakens, and the body cannot cope with the load. In this case, the bacteria multiply and spread rapidly, causing infections and complications.

To find out about the presence of bacteria, a nursing mother can do an analysis of breast milk. This will protect the woman and the baby and prevent illness. In addition, there are a number of cases when it is mandatory to take an analysis of breast milk.

When is the analysis done?

• Purulent mastitis in a nursing woman;
• Recurring mastitis in the mother during lactation;
• Inflammation and pain in the chest, purulent discharge from the nipples;
• Violation of the work of digestion and the process of nutrition in infants for no apparent reason;
• Negative and unstable stools in infants during the first two months of life. If impurities of blood and mucus are observed, and the stool itself is dark green in color. What should be the chair of the baby, read;
• Constant colic in the baby, constipation or diarrhea. In this case, the baby does not gain or even lose weight. About the norms of the weight of a newborn up to a year, you can find out in;
• The baby had pustules and blisters on his body.

How to collect milk for analysis

To get reliable results, you need to perform a number of actions. First of all, you need to prepare the dishes. To collect milk, take two jars or test tubes, which must be disinfected! To do this, rinse the container with soda, rinse in running water and boil for 30-40 minutes. In addition, you can take special sterile test tubes directly to the laboratory where breast milk is analyzed.

Wash your hands and chest thoroughly before pumping. Wash your chest with liquid neutral soap and wipe with a napkin. Towels and ordinary soap irritate the nipples, which leads to cracks and abrasions! Wipe the nipples and areola with a 70% alcohol solution. How to express milk correctly, the heading "" will tell. Skip the first 10 ml and only then decant into a container.

It is important to express milk from each breast into a separate jar! Sign the jars. where is the milk from the right breast, and where from the left. For analysis, it is enough to collect 5-10 ml of milk from each breast. You need to deliver milk to the laboratory within three hours! You need to wait about a week for the result.

results

Often the mother's fears are in vain, and digestive disorders are associated with other problems. For example, with an unhealthy diet, a nursing woman or a baby may be allergic to the product. And colic in a newborn is a temporary phenomenon that is typical for 80-90% of babies. They do not mean at all that harmful microorganisms have settled in breast milk.

Sometimes the analysis of breast milk for sterility shows the presence of bacteria. However, not all substances are harmful to mother and baby. Antibodies in breast milk block germs, protect the baby, and build immunity in the baby.

The most common bacteria are staphylococci. They are formed on the skin, mucous membranes and in the intestines. They enter breast milk through cracks and sores on the nipples. Antibodies neutralize and staphylococcus aureus. However, with a weakened immune system, harmful bacteria can spread throughout the body.

Bad analysis: what to do

These diseases are treated and do not even require interruption of breastfeeding. Breastfeeding should be interrupted only with purulent mastitis and long-term treatment with drugs that are not compatible with lactation.

Infection prevention

The main cause of infections is cracks and abrasions on the nipples. To avoid the appearance of wounds, it is necessary to carefully monitor the hygiene and condition of the breast. For prevention, use the following methods:

• Wash nipples with neutral liquid soap and dry with a paper towel or tissue;
• Choose the right bra for breastfeeding. Bones and fabric should not rub the delicate skin of the nipples;
• Lubricate the nipples with vegetable or olive oil;
• For the prevention of wounds and cracks, solutions of vitamins A and E are well suited. They protect and restore the skin, improve skin elasticity. Also, Purelan ointment is suitable as a prophylaxis;
• If cracks have already appeared, use special ointments to treat nipples while breastfeeding. Videstim and Bepanten are effective and safe. If you use a furatsilin solution, be sure to wash off the mixture before feeding!;
• Do breast massage using circular movements clockwise for 2-4 minutes a day;
• Take warm showers in the morning and evening. By the way, massage can be done during the shower;
• Pain in the chest is relieved by compresses from cabbage leaves. To enhance and facilitate lactation, make a warm compress before feeding, and a cool one after;
• Make sure that the baby captures both the nipple and the areola !;
• Carefully monitor the condition of the chest. If there are lumps, stagnation of milk or discharge of pus from the nipples, consult a doctor! Even the usual stagnation of milk (lactostasis) and microcracks that are not visible to the eye, if not properly treated, lead to complications and serious diseases;
• With lactostasis, mastitis and other breast problems, it is necessary to take an analysis of breast milk.

An important role in the health of the baby is played by proper nutrition of a nursing mother. .Dishes containing vitamins and useful elements will help a woman recover faster after childbirth and strengthen her immune system, which is important in the fight against harmful microbes.