How to Keep Bacteria Out of Breastmilk Substitutes and Pumped Milk

There has been a lot in the news lately about babies getting sick–and even dying–from Cronobacter bacteria in their milk. Most of the time, this is due to contaminated powdered breastmilk substitute (formula), but there have actually been cases where the bacteria was found in pumped milk that was expressed using contaminated pump parts.

These are such heartbreaking stories. Even though they are rare, each one is a devastation for the families of these babies. I’m so glad that there is more information being shared now about these dangers. It’s leading to stricter regulations for producers of breastmilk substitutes and a better understanding of good hygiene practices for families, which is great for preventing all kinds of germ contamination.

The Cronobacter bacteria is not rare or especially dangerous in most cases. It can be found all over the place and is rarely harmful to humans. Unfortunately, for newborn babies or older babies who are sick or were born prematurely, exposure to it can be life threatening. But like many of the concerns that parents have, knowledge is power. Knowing more about this kind of bacteria and infections can definitely help you prevent your baby from getting sick.

How to Prevent Contamination

There are many ways to prevent contamination with this bacteria. Not all of these methods are possible for every family, but there is something that everyone can do to lower their risks.

Feed your baby directly from the breast. The bacteria does not exist in breast milk, only in contaminated pump parts or bottles/nipples, so allowing the baby to feed directly from the breast is a way that you can prevent this infection. Lactation consultants usually recommend ONLY direct breastfeeding in the first few weeks anyway. It’s the best way to ensure a great milk supply from the beginning and will usually mean that breastfeeding and later pumping/bottle feeding go more smoothly.

Watch for formula recalls before buying. Parents, the FDA, and formula producers are being more mindful about the safety of breastmilk substitutes because of recent events. Problems are being detected more quickly, and then recalls and warnings get issued faster. The FDA regulates the safety of breastmilk substitutes, and their website may be the most reliable and current source of information. It’s a great idea to check on this each time you buy.

To find out about your specific product, find the LOT NUMBER on the bottom of the product and enter it into a checker on that company’s website or call the number provided on the package or website to check that batch.

Make sure you are following safe handling practices when using and storing breastmilk substitutes. The CDC has this great infographic to show you the best practices for using breastmilk substitutes so you can prevent Cronobacter infection. It’s important to follow these guidelines carefully ESPECIALLY when the baby is younger than two months, or if your older baby was born prematurely or has a weakened immune system due to illness.

Regularly and thoroughly clean and sanitize pump parts and bottles/nipples. It’s true that breast milk itself cannot carry the Cronobacter bacteria, but if you are pumping your breast milk using contaminated pump or bottle parts, it can get into the milk. It’s important to follow safe handling practices when pumping and using bottles to feed your baby breast milk.

Recognizing a Cronobacter Infection

Even if your baby is exposed to the Cronobacter bacteria, they won’t necessarily get sick. But if they do, it’s a great idea to know what to look for in the early stages of illness. Take your baby to the doctor if you see the following symptoms:

• Fever
• Feeding poorly
• Excessive crying
• Very low energy
• Seizures

Babies receiving treatment with antibiotics in the early stages of illness usually do well. Not all babies get severely ill or die from a Cronobacter infection. The biggest concern is that newborn babies and babies with weak immunity could get necrotizing enterocolitis, sepsis, or meningitis if left untreated for too long.

Necrotizing enterocolitis is when the bacteria causes severe problems in the intestines. Sepsis and meningitis are possible if the bacteria gets into the bloodstream. Then there is infection throughout the body via the bloodstream, and in the case of meningitis it travels into the brain through the bloodstream.

All of these infections are life threatening and more difficult although not impossible to treat. They are responsible for the deaths that occur due to a Cronobacter infection. That’s why it’s important to play close attention in the early weeks with your newborn and make sure that you are following the guidelines for safe prevention.

Remember that these severe Cronobacter infections are extremely rare, and once your baby has a more developed and healthy immune system, Cronobacter will no longer be a threat. Until then, it’s a great idea to take some extra precautions to keep those risks even lower.

Watch this video interview with Registered Dietician Janel Davis for more information and tips about Cronobacter bacteria and safe handling of formula. Janel also teaches the Formula 101: What You Need to Know class with Breastfeeding Success.