Testing breast milk for sterility is a fairly reliable and reliable way to test breast milk for the presence of harmful bacteria that cause intestinal disorders and various types of infectious diseases in the baby, as well as inflammatory processes in the mother.

Contrary to misconceptions, breast milk is not an absolutely sterile food for a baby - germs, bacteria and other microflora can live in it, which can be either safe for the health of mother and child or pose a certain threat. To study this microflora, it is necessary to submit milk for analysis.

How can bacteria get into breast milk? This usually occurs through microcracks in the nipples. In themselves, such cracks are not at all dangerous and do not cause pain, but with the slightest weakening of the nursing mother’s body, pathogenic staphylococci, streptococci and fungi have every chance of penetrating into the milk through these vulnerable areas of the skin. The occurrence of microcracks when a baby is constantly attached to the breast is inevitable.

Indications for analysis

Bacteriological examination of breast milk is mandatory in the following cases:

• if a nursing mother has suffered purulent mastitis;
• if in the first two months of life the baby experiences sharply unstable stools (dark green in color, mixed with mucus and blood), colic, constipation and diarrhea in combination with low weight gain;
• if the child has purulent-inflammatory diseases or sepsis.

Thus, most often it is necessary to take an analysis in case of recurring mastitis in a nursing mother, and in more rare cases - to find the causes of diseases and disturbances in the feeding and digestive processes of the baby.

Preparing for analysis

To submit milk for analysis, it is necessary to be careful and extremely precise when collecting it - this is what guarantees that the results of breast milk analysis will be reliable. It is important to understand that breast milk must be collected in such a way as to minimize the possibility of bacteria from the skin getting into it.

To collect breast milk, two sterile tubes are needed - one for each breast. Also, glass jars that have been thoroughly washed and sterilized in boiling water can be used as containers. They will need to be signed so that it is clear which contains the sample from the left breast and which contains the sample from the right.

Immediately before collecting milk for analysis, hands and breasts should be thoroughly washed with soap. In addition, the areola area can be treated with an alcohol solution or a sterile wipe. Then you need to express the first portion of milk from each breast into the sink, and the second (about 10 ml) into a pre-prepared container.

Breast milk samples must be delivered to the laboratory for diagnosis within two to three hours of collection. If you take a breast milk test later, you may get inaccurate or completely wrong results. Typically, the duration of such a study is at least a week - this time is necessary for bacterial colonies to have time to grow and multiply in nutrient media.

Analysis Process

To conduct the study, breast milk is sown on a specially prepared nutrient medium, and then placed in an incubator. Within a few days, colonies of microorganisms form in the nutrient medium. The specialist examines them and counts the number, thereby determining the types and number of microbes contained in breast milk.

Simultaneously with the study of the quantity and quality of bacteria, the analysis process can provide information about the resistance of identified microorganisms to the effects of various drugs - antibiotics and antiseptics. This will help you find the optimal remedy to fight the infection and prescribe the most effective treatment.

Analysis results

It is very important to understand that the presence of bacteria in breast milk does not necessarily indicate the development of a dangerous infectious process and does not always require stopping feeding and carrying out any therapy. Microorganisms found in breast milk can be transferred to your milk when you express it from your hands or breasts. Thus, the detection of bacteria may be associated with common defects in the collection of material for analysis.

In addition, one should not lose sight of the fact that during feeding, the baby in any case comes into contact with microbes located on the mother’s skin, so even complete sterility of breast milk does not protect the child. So any disturbances in the baby’s digestive process can be associated with the results of bacteriological analysis of breast milk only in very rare cases - with the direct detection of pathological microorganisms.

In some cases, indications for culture of breast milk may include recurrent purulent-inflammatory skin diseases in a child or sepsis. In such situations, based on the results of the analysis, it is possible to prescribe special therapy and even stop breastfeeding. Also, breastfeeding is stopped if representatives of pathogenic microflora, such as salmonella or cholera vibrios, are detected in the milk.

Very, very many breastfeeding mothers who had to have their breast milk tested are found to have opportunistic microorganisms. The most common of these are Staphylococcus aureus and Staphylococcus epidermidis. But it should be noted that both of these microorganisms belong to normal representatives of the microflora that live on human skin. Therefore, when identifying them, there is no need to sound the alarm.

At the same time, both Staphylococcus aureus and Staphylococcus epidermidis can cause mastitis. These microorganisms belong to opportunistic microflora, which means that they can either quietly reside in the milk ducts without causing any harm to the mother and baby, or cause diseases. However, for this they need certain conditions, such as weakened immunity, poor nutrition.

If you submit milk for analysis without the presence of any signs of mastitis, but find harmful bacteria in it, the doctor usually prescribes a course of treatment for the mother, and prescribes lacto- and bifidobacteria for the baby to prevent dysbacteriosis. As a rule, antibiotics are used extremely rarely in such cases - usually the doctor selects some herbal antiseptics or bacteriophages that will not affect lactation in any way and will not require stopping breastfeeding.

In what cases is culture required for sterility? How to properly prepare for analysis. How do laboratories culture and identify microbes? Decoding the results. What to do if the bacteria limit exceeds.

Woman's milk is a complex biochemical element. It can build the baby’s immunity and strengthen his health. Therefore, breastfeeding is the best food for a child in the first months of life.

But it happens that during breastfeeding a woman may develop an infection, and then there is a danger of harmful bacteria getting into the milk. What can a sterility test tell you and how is it carried out?

When milk is examined in the laboratory, the number of bacteria is determined, and then treatment is prescribed. Insidious microorganisms penetrate a woman’s breast through small microcracks when the baby is feeding.

These microcracks form in all nursing mothers, but the penetration of harmful bacteria occurs only in those whose bodies are weakened, resulting in a weakened immune system. Constant lack of sleep and overwork cause the body to weaken, and it becomes vulnerable to infections.

Breast milk testing is required in the following cases:

• When any postpartum infection is detected in the body.
• In case of premature birth.
• If the baby has pustules and rashes.
• For loose stools and diarrhea in a baby.
• Milk donation.
• Lactose, when a woman's milk stagnates.
• Mastitis is when the mammary gland becomes inflamed.

Sowing is necessary in all of the above cases. Since it is this analysis that allows us to identify what caused the disease, determine the pathogen, and prescribe treatment. As a rule, in such cases, doctors require you to stop feeding.

Preparing for sowing

Before you start collecting milk, you need to prepare a special sterile container. At the next stage, you need to treat your hands and chest, first wash them with soap, then treat them with alcohol. The first 5 milliliters are not taken for analysis, so they need to be drained.

Then 10 ml is expressed from each breast and poured into prepared containers. The container is closed with a lid. Each container is labeled, indicating the age of the nursing mother, last name, and from which breast the breast milk was taken.

It is advisable to hand over the collected material to the biological laboratory within two to three hours, but if this is not possible, then it can be kept in the refrigerator for no more than 24 hours

How do laboratories perform cultures to identify microbes?

To correctly determine the sterility of breast milk, samples are specially sown on a special nutrient medium. Then it is placed in an incubator and kept for some time until colonies of bacteria appear. Then, they are counted and the number of microorganisms in breast milk is determined.

Each of us knows how beneficial breastfeeding is for babies. However, recently, medicine has come to the conclusion that bacteria in breast milk can pose a danger to the health of babies, causing various diseases of the gastrointestinal tract. In this regard, many breastfeeding women prefer to have their breast milk tested to ensure it is sterile.

It is important to understand that breast milk cannot be absolutely sterile, since the excretory flows of the mammary gland are located on the skin, which is populated by a variety of microorganisms. Therefore, the presence of microbes is completely normal. The main thing is that their content in milk does not exceed permissible limits.

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What do breast milk tests mean?

Analysis of breast milk allows you to determine the number of microbes it contains:

• staphylococci;
• streptococci;
• fungi;
• coli;
• enterococci.

What is the principle of analysis?

To test breast milk for sterility, you need to submit a small amount for analysis. In laboratory conditions, milk is placed in a nutrient medium and stored for some time in an incubator. After a few days, entire colonies of a wide variety of microbes appear in the nutrient medium (as required by the analysis). After recalculating the resulting microbes, it is possible to determine the average indicator of their existence in the composition.

Analyzes of breastfeeding mother's milk require care and precision during collection. Only in this way can the reliability of the analysis be guaranteed. The collection mechanism must completely eliminate the possibility of microorganisms entering the sample from the surface of the skin of the hands or chest. The necessary sterility is achieved through the use of exclusively clean containers and hands that are thoroughly washed and treated with alcohol.

In what cases does such an analysis become necessary?

There are several cases when nursing mothers are advised to have their breast milk tested for sterility:

• in the case of purulent mastitis suffered by a nursing woman;
• if a child develops sepsis or purulent-inflammatory diseases;
• if the baby develops unstable stools, diarrhea, constipation, colic in the first two months of his life (where the stool is dark green with impurities of blood or mucus);
• in case of slight weight gain during the first months of life.

Breast milk research at the Clinic of Modern Medicine

The Clinic of Modern Medicine IAKI offers many qualified services, one of which is the analysis of breast milk for sterility. Our experienced specialists always recommend milk testing to nursing mothers, even in the absence of alarming symptoms. Caring for the health of babies, our doctors strive to completely eliminate the possibility of various diseases occurring in the first months of their life.

If an analysis of breast milk shows a high content of harmful microorganisms, our specialists will offer an effective course of treatment using modern methodologies and progressive drugs. The effect of the proposed drugs is not capable of influencing lactation and the health of the baby. Therefore, during treatment, the milk remains suitable for feeding the baby. Only in the most extreme cases can antibiotics be prescribed, the use of which requires interruption of feeding.

In the future, to ensure that breast milk remains sterile, our doctors will advise the nursing woman on proper nutrition and proper care of her breasts.

It is genetically determined that breast milk contains everything necessary for a child to develop correctly and harmoniously. Moreover, the quantitative ratio of the elements of this nutrient fluid differs for each woman depending on the individual needs of the baby, his age and the duration of each feeding. If the baby is not gaining weight well, behaves restlessly or requires frequent breastfeeding, the mother doubts whether her milk has sufficient fat content. Let's try to determine where the problem most often lies.

For a child, the milk that he receives from his mother - both water and food, are delivered to the baby with it:

The fat content of breast milk is a dynamic (changeable) value. It may vary depending on how much time has passed since the start of breastfeeding (what stage of lactation). The percentage of fat in milk will also vary as the baby sucks it from the breast during one feeding. Based on this, mother's milk is divided into types.

Types of mother's milk at different stages of breastfeeding - table

The content of certain organic substances in breast milk may change in different life situations, for example, if:

The composition and properties of breast milk have not been fully studied to this day. It is known that it contains about 500 components, each of which plays its own role, clearly provided for by nature, in the maintenance and development of new life. Fats are no exception. There are exactly as many of them in mother’s milk as the baby of this particular mother needs at a certain stage of life.

How many biologically active substances depending on the stage of lactation - table

The qualitative composition of mother's milk remains unchanged throughout the entire period of lactation; the quantitative indicators of the content of useful substances change depending on the needs of the baby. Moreover, these changes occur smoothly, and not abruptly.

Anterior and posterior - classification within one feeding

Breast milk is a truly unique product. It can change in composition during one feeding. First, the baby sucks from the breast the so-called foremilk, which contains more water and less nutrients, then, towards the end of feeding, he gets the thicker, fattier and more nutritious hindmilk.

Foremilk is produced in the time between feedings. The posterior one matures directly during feeding - its fat content increases due to the fact that fat molecules accumulated on the walls of the milk ducts are washed out with milk and gradually move to the nipple (this is why milk is fatter towards the end of feeding).

Foremilk, white or bluish in color, tastes sweet due to its high sugar content, replenishes the baby's body's fluid supply. The back, yellowish, contains everything necessary for the growth and development of the baby, gives a feeling of fullness, and takes longer to digest.

The baby's body needs both types of milk equally. This is why it is so important that the baby receives both front and back during feeding. To do this, it is recommended to put the baby on only one breast at one feeding.

Chemical composition of breast milk - table

How to understand whether fat content is normal and whether it is worth increasing it

During lactation, a woman produces milk exclusively with the participation of blood and lymph. The products consumed by a nursing mother do not in any way affect its composition - they replenish the reserves of nutrients in the mother’s body and can stimulate the production of more milk. But the correct placement of the baby to the breast and compliance with the rules of breastfeeding are directly related to the child’s feeling of fullness and age-related indicators of his development.

Most often, it is enough to properly establish lactation to get rid of the baby’s problems with digestion and weight gain. As for the fat content of breast milk, in most cases it corresponds to the norm, and it should not be specially increased in order to avoid the development of dysbiosis in the baby and disturbances in the functioning of the gastrointestinal tract. There are also always exactly as many other substances in milk as the child needs in accordance with his age and anthropometric data.

Mother's milk consists, first of all, of water - 90% fore milk, 87% hind milk - therefore it is believed that it is not necessary to supplement a baby who receives it in sufficient volume (when feeding on demand). Carbohydrates in it are represented by milk sugar and lactose, in the amount of 7% of the total volume, and it contains 4% fat. And there are only 1% of vitamins and minerals, but they are absorbed from breast milk into the baby’s gastrointestinal tract much more actively than from any other products.

In breast milk, the ratio of proteins, fats, carbohydrates is ideal for absorption by the child’s body - 1: 3: 6. For comparison, in cow milk this ratio is 1:1:1. Fats in human milk are mainly represented by triglycerides, sterols, and phospholipids.

It has been experimentally proven that changing the diet of a nursing mother can only affect the level of polyunsaturated fatty acids, water-soluble vitamins and some minerals (selenium, iodine) in breast milk. The viscosity and fluidity of milk can vary depending on the amount of lecithin consumed by a woman.

This means that the problem of a hungry child is often not that his mother is eating incorrectly, but that she is not breastfeeding the baby correctly. This is a situation in which it is more likely to adjust the feeding regimen, monitor the correct attachment of the baby to the breast, make sure that he sucks both fore and hind milk, and not increase its fat content.

If you still doubt the nutritional value of your breast milk, you can find out its fat content: check it yourself at home or submit it for laboratory testing.

How a woman can check her fat content at home or by taking a test in a clinic

Hind milk is the main source of fat for the baby. This means that the percentage of their content in it should be determined. To determine the fat content of your milk, a nursing mother needs:

If the thickness of the cream layer in the test tube is approximately 4 mm, the fat content of the milk corresponds to the standard. Remember that there may well be deviations from this value due to the individual characteristics of the body and the developmental characteristics of the baby.

To determine the fat content of milk, the fore milk is first expressed into a separate container, and the percentage of fat is determined by its content in the hind milk

Due to the inaccuracy of the results, such a home test cannot be recognized by official medicine. If there are suspicions of deviations from the norm in the content of active substances in milk, the nursing mother is prescribed a laboratory analysis that accurately determines its quantitative and qualitative composition (chemical tests). But such an analysis is done only if there are serious dysfunctions of the endocrine system or other pathologies in the mother, mainly in private laboratories, and the cost of performing it is far from small.

Often problems with the quantity and quality of breast milk during lactation arise:

These conditions require immediate access to qualified medical care. In other cases, in order for the baby to receive milk of sufficient fat content and rich in all the necessary nutrients, it is enough to simply follow the rules of breastfeeding and the nursing mother to eat properly.

The higher the fat content of the milk, the more effort it will require to digest it, the harder it will be for the baby to suck and for the mother to express. Therefore, there is no need to consciously increase the fat content of milk by consuming large quantities of fats (sour cream, pork, butter creams, etc.). Vegetable fats (sunflower, olive and corn oil) are preferable to animal fats.

E. O. Komarovsky

Is it possible to increase the nutritional value of milk and solve the problem of child underweight?

A child and a nursing mother are connected by a common microflora. If an infection develops in the mother’s body and she feels unwell, then similar reactions will be observed in the baby’s body. Therefore, the first rule of breastfeeding is this: at the slightest suspicion of developing any disease, a nursing mother should immediately consult a doctor to get medical help and eliminate any cause that could negatively affect the production and quality of the baby’s main food - breast milk.

Nature has made sure that the child receives everything he needs from his mother. Mom must eat right so as not to let the reserves of nutrients in her body dry up. But as doctors say, she needs to eat for two, not for two. What does it mean? In short, cereals and fruits should make up 50% of her diet, fats - 30%, proteins - 20%, and she needs to drink a lot of water - at least 2 liters per day.

The formula for a healthy diet for a nursing mother is simple to the point of banality. But it guarantees the provision of all necessary benefits to both the woman and her baby.

As mentioned above, fat content directly depends on the intervals between feedings - the shorter they are, the more fatty food the child receives. Feed your baby more often, while trying to eat small portions at short intervals (from 5–6 to 8 times a day - the mother eats the same number of times as she puts the baby to her breast). This is the only way your body and the baby’s body will receive nutrients in doses, without unnecessarily loading the organs of the digestive system. And all the active components will be absorbed by both to the fullest extent.

Always make sure that your baby receives both foremilk and hindmilk at the same feeding. Attach your baby to the breast correctly so that he grasps the nipple completely. In most cases, it is these simple actions that help cope with the problem of a child’s lack of nutrients and poor weight gain.

Only with severe exhaustion of the body, prolonged fasting, anorexia, or serious pathologies of the endocrine system in a woman can milk be “empty” - low-fat.

Always make sure you are latching your baby to your breast correctly.

If breast milk is produced in insufficient quantities, drink special teas that stimulate lactation. They do not directly increase fat content, but by increasing its production, they are quite capable of solving the problem of child underweight.

There are many recommendations regarding products that increase the amount of milk (nuts, yeast, nettle decoction, beer, etc.), as well as medications that have a similar effect (nicotinic and glutamic acids, Apilak, Pirroxan). But you should under no circumstances overestimate their importance. Believe me, a healthy child and a mother who sleeps at night, who is not nervous and does not twitch over little things, contribute to the production of a sufficient amount of milk to a much greater extent than all food and medicines combined.

E. O. Komarovskyhttp://www.komarovskiy.net/knigi/pitanie-kormyashhej-materi.html

What products help improve the quality of lactation - photo gallery

Milk and lactic acid products are rich in easily digestible fats and calcium. Among cereals, buckwheat is considered the record holder for vitamin composition. You can eat different types of meat, but it is better to stew, boil or bake it

How to improve the quality of lactation - video

And if the fat content is increased: how to determine and what to do

Situations when a child, on the contrary, gains weight too quickly, are also not uncommon. Then the nursing mother, on the contrary, wonders how to reduce fat content. But again, first you need to conduct examinations with a pediatrician to exclude such causes of excessive weight gain in infants, such as:

If the reason for the discrepancy between the child’s weight and age lies precisely in the too high nutritional value of his diet, the doctor may recommend that the woman limit her intake of carbohydrates and fats, cancel night feedings or increase the intervals between daytime feedings. After all, too much fat in the diet can cause the baby to develop dysbiosis, obesity, and dysfunction of the digestive and cardiovascular systems.

Not a single doctor will advise a nursing mother to follow any diet (especially mono) and deprive herself of the necessary variety of nutrients entering the body with food.

This is not about eliminating fatty foods, but about eating them in smaller quantities. It is generally unacceptable to completely eliminate fats, for example, when fighting for your figure, if only because many vitamins dissolve exclusively in fats.

E. O. Komarovsakiyhttp://www.komarovskiy.net/knigi/pitanie-kormyashhej-materi.html

Nature has made sure that the composition of breast milk fully meets the needs of the child. It is necessary to specifically increase or decrease its fat content only in cases of pathological changes in the body of either a nursing woman or her baby. In most cases, to normalize a baby’s digestion and bring its anthropometric indicators to meet age standards, it is enough to properly establish lactation, follow the rules of breastfeeding and adjust the diet of the nursing mother.

Description

Determination method bacteriological, bacterioscopic

Material under study Breast milk

Home visit available

Determination of contamination of mother's milk.

The study is especially necessary for women suffering from postpartum (lactation) mastitis. This is the most common complication after childbirth. It is extremely dangerous that its initial forms, serous and infiltrative, can quickly turn into a purulent form, even gangrenous.

The main pathogen is Staphylococcus aureus, which is characterized by high virulence and resistance to many antibacterial drugs. No less dangerous are epidermal staphylococcus, streptococcus, enterobacteria, Pseudomonas aeruginosa, etc. All of them are characterized by high virulence and multiresistance to antibiotics. Therefore, accurate determination of the pathogen and its sensitivity to antibiotics is extremely important.

This is due to the fact that, regardless of the pathogen, the clinical picture is almost identical: usually at 2-4 weeks of the postpartum period, the temperature quickly rises to 38-39 degrees, and chills occur. Mastitis often turns into a purulent form after 2 - 4 days.

If breastfeeding continues, infected mother's milk and especially necessary antibiotic therapy can have an adverse effect on the newborn (dysbacteriosis).

We draw your attention to the need to purchase a sterile container for collecting urine and other biological fluids, which must be purchased in advance at any INVITRO medical office with a deposit. Deposit funds are returned upon completion of the analysis and subject to a receipt for the deposit.

Literature

1. Methodological recommendations for bacteriological control of breast milk. Main Directorate of Treatment and Preventive Care for Children and Mothers. USSR Ministry of Health, 1984
2. Medical microbiology, virology and immunology: Textbook / Ed. A.A. Vorobyova. - M.: Medical Information Agency, 2004. - 691 p.

Preparation

The study is carried out before antibiotics are prescribed for mastitis and a few days after the end of treatment. Milk from the right and left mammary glands is examined separately. 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.

Indications for use

• Mastitis in nursing women.
• Monitoring the effectiveness of antibacterial therapy.
• Dysbacteriosis in breastfed and mixed-fed children.

Interpretation of results

Interpretation of research results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.

The presence or absence of growth, total contamination, and the type of grown microorganisms in the culture are indicated.

Interpretation: normal - no growth. When contaminated with accompanying flora, 1 or more types of bacteria are isolated in low titer (most often it is S. epidermidis). Staphylococcus aureus, Escherichia coli bacteria, and Pseudomonas aeruginosa are considered etiologically significant.

The total contamination is indicated as follows:

Massive growth: if the bacterial growth in breast milk is more than 250 CFU/ml;

Non-massive growth: If the bacterial growth in breast milk is less than 250 CFU/ml.

The question of stopping breastfeeding is decided by the attending physician, based on test results and existing signs of the disease.