Microbiological Assessment of Fresh Expressed Breast Milk on Room Temperature at Dr. Soetomo Hospital Neonatal Unit

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Expressed breast milk (EBM) has been advocated as an effective way for encouraging and maintaining lactation when the mother is separated from the baby for a while. Storing EBM at room temperature in several hours before consuming, frequently found in Indonesia. Based on WHO guidelines EBM can last for 6 to 8 hours in room temperature. But currently there hasn’t been study in tropical country especially Indonesia for the guidelines. Assesing microbiological quality of EBM on room temperature, including bacterial growth and major bacterial found on EBM for health care and society recommendations. An observational study of 30 expressed breast milk samples provided by 30 healthy women with term baby below 6 month old. EBM were collected by electric breast pump swing model. The samples were kept sterile and laid at plates for 2 hours, 4 hours and 6 hours in room temperature (26o- 32oC) and used drop plate technique on several culture media. Data was analyzed by Chi-square and paired sample T-test. Thirty of unheated fresh EBM from 30 lactating mothers were stored at room temperature, examined for the degree of bacterial contamination at 0 hour, 2 hours, 4 hours, and 6 hours. All the EBM samples were contaminated at 2 hour. There were strong correlation between 2 hours storing with 4 hours storing (p=0.004) and total colony (p=0.000). There were also significant difference between bacterial colony and the duration itself (p=0.026). Bacterial species identified was Coagulase-negative Staphylococcus (CNS), Escherichia coli, Klebsiella pneumoniae and Streptococcus faecalis, range of growth 109 cfu/ml - 63 x 109 cfu/mm3 after 6 hour of storage. Evaluation result that the EBM exposed at room temperature (30-36 0C) for more than two hour reduce the quality and do not recommended to be given to the infants because bacterial counts > 104 cfu/ml and the present of pathogens E. coli, Streptococcus faecalis and Klebsiella pneumoniae.