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

Nur Aisyah Widjaja, Kartika Hardiyani, Meta Herdiana Hanindita, Roedi Irawan

= http://dx.doi.org/10.20473/fmi.v55i1.24346
Abstract views = 294 times | downloads = 165 times


Storing EBM at room temperature in several hours before consuming, frequently found in Indonesia. Based on Academy of Breastfeeding Medicine guidelines EBM can last for 6 to 8 hours in room temperature (25oC or 77oF). However, currently there hasn’t been study in tropical country especially Indonesia for the guidelines. This study aimed to assess 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. The samples were kept sterile and laid at plates for 0 hours, 2 hours, 4 hours and 6 hours in room temperature (26°-32° C) 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. 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. 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. 

Full Text:



Asquith M and Harrod J (1979). Reduction of bacterial contamination in banked human milk. J Pediatr. 95, 993-994

Boo N, Nordiah AJ, Alfizah H, Lim VKE (2001). Contamination of breast milk obtained by manual expression and breast pumps in mothers of very low birthweight infants. J Hosp Infect. 49, 274-281

Bransburg-Zabary S, Virozub A, Mimouni A (2015). Human Milk Warming Temperatures Using a Simulation of Currently Available Storage and Warming Methods. PLoS ONE. 10, 1-13

Cunha M, Sinzato L, Silveira Y (2004). Comparison of Methods for the Identification of Coagulasenegative Staphylococci. Mem Inst Oswaldo Cruz. 99, 8558-8560

Delgado S, Arroyo R, Jiménez E, Marín ML, Del Campo R, Fernández L, Rodríguez JM (2009). Staphylococcus epidermidis strains isolated from breast milk of women suffering infectious mastitis: potential virulence traits and resistance to antibiotics. BMC Microbiol. 9, 82-93

Donowitz LG, Marsik FJ, Fisher KA, Wenzel RP (1981). Contaminated breast milk: a source of Klebsiella bacteremia in a newborn intensive care unit. Rev Infect Dis. 3,716-720

Dorota P, Chmielarczyk A, Katarzyna L, Piotr M, Jan L, Renata R, Jadwiga W (2017). Klebsiella pneumoniae in Breast Milk-A Cause of Sepsis in Neonate. Arch Med. 9, 1

Eidelman A, Szilagyi G, (1979). Patterns of bacterial colonization of human milk. Obstet Gynecol. 53, 550-552.

Fitzstevens J, Smith KC, Hagadorn JI, Brownell EA (2017). Systematic Review of the Human Milk Microbiota. Nutr Clin Pract. 32, 354-364

Gindrat J, Gothefors L, Hanson L, Winberg J. (1972). Antibodies in human milk against E coli of the serogroups most commonly found in neonatal infections. Acta Paediatr Scand. 61, 587-590

Gransden WR, Webster M, French GL, Phillips I (1986). An outbreak of Serratia marcescens transmitted by contaminated breast pumps in a special care baby unit. J Hosp Infect. 7, 149-154

Henker J (1987). Collection and preservation of breast milk. Monatsschr Kinderheilkd. 35, 231-234

Ighogboja I, Odumodu C, Olarewaju R (1996). Breastfeeding pattern in Jos, Nigeria, before Baby Friendly Hospital Initiative. J Trop Pediatr. 42, 178-179.

Karimi M, Eslami Z, Lotfi MH, Nori S, Zandi H, Taghipour-Zahir S, Akhondzardaini R (2013). Bacterial contamination of expressed breast milk in neonatal intensive care unit. J Res Health Sci.13, 43-47

Li S, Watanabe K, Hsu C, Chao S, Huang H, Chang C, Moore RJ (2017). Bacterial Composition and Diversity in Breast Milk Samples from Mothers Living in Taiwan and Mainland China. Front Microbiol. 8, 965

Lorico JLL, Perez L, Makati O (2012). Effect of storage process on the bacterial growth-inhibiting activity of expressed human breast milk on common neonatal pathogens, Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae. PIDSP Journal. 13, 2-7

Marin ML, Arroyo R, Jimenez E, Gomez A, Fernandez L, Rodriguez JM (2009). Cold Storage of Human Milk: Effect on Its Bacterial Composition. J Pediatr Gastroenterol Nutr. 49, 343-348

Martinez-Costa C, Silvestre DM, Lopez MC, Plaza A, Miranda M, Guijarro R (2007). Effects of Refrigeration on the Bactericidal Activity of Human Milk: A Preliminary Study. J Pediatr Gastroenterol Nutr. 45, 275-277

Mense L, Rößler S, Mense L (2013). Bacterial Contamination of Mechanically Extracted Breast Milk. Am J Perinatol. 31, 293-298

Obiajuru IOC, Ikpeama CA, Ilo JCE (2017). Microbiological assessment and storage quality of expressed breast milk. IJMPD. 1, 5-9

Ogundele M (2000). Techniques for storage of human breast milk: implications for anti-microbial functions and safety of stored milk. Eur J Pediatr. 159,793-797

Serafini ÁB, André MCDPB, Rodrigues MAV, Kipnis A, Carvalho CO, Campos MRH, Jubé TFN (2003). Microbiological quality of human milk from a Brazilian milk bank. Rev Saude Publica. 37, 775-779

Serra V, Teves S, López de Volder A (2013). Comparison the risk of microbiological contamination between samples of breast milk obtained at home and at a healthcare facility. Arch Argent Pediatr. 111, 115-119

Szollosy E, Marjai E, Lantos J (1974). Bacterial contamination and sparing heat treatment of mother's milk. Acta Microbiol Acad Sci Hungarian. 21, 319-325

Tully M (2000). Recommendations for handling of mother's own milk. J Hum Lact. 16,149-151

Zinn B (2000). Supporting the employed breast feeding mother. J Midwifery Womens Health. 45, 216-226


  • There are currently no refbacks.

Copyright (c) 2021 Nur Aisyah Widjaja, Kartika Hardiyani, Meta Herdiana Hanindita, Roedi Irawan

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Indexed By

View My Stats

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.