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Exclusive breast-feeding best to protect against Cronobacter
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Exclusive breast-feeding is optimal, but for mothers who cannot or choose not to breast-feed, use of ready-to-feed formulas and avoiding powdered formulas during the first 2 months of life are reasonable options to avoid Cronobacter infections, according to study data published online.
Janine Jason, MD, of Jason and Jarvis Associates, Hilton Head Island, S.C., published a review of 98 Cronobacter cases between 1958 and 2010. She said 90% of the infants had received powdered infant formula or human milk fortifier — and some of these occurred even though FDA guidance was followed. Infants were at greatest risk during the first 2 months of life, and the infections often occurred at home.
These infections were rare in children who were exclusively fed breast milk and/or ready-to-feed formulas, which are commercially sterile.
Jason said clinicians play an important role in educating parents that powdered formulas are not sterile and can, on occasion, contain pathogenic bacteria, so the parents can make informed decisions about their infants’ nutrition.
“Following safe preparation, feeding, and storage guidelines minimizes the risk of contamination by environmental organisms, but following these guidelines will not assure safety from Cronobacter infection,” Jason said in an interview with Infectious Diseases in Children. “Proper handling plus exclusive breast-feeding or using ready-to-feed varieties would minimize the risk of Cronobacter.”
The average annual number of Cronobacter infections worldwide increased from 1.5 in 1958 to 4.3 in 2010, according to Jason.
Janine Jason, MD can be reached at JJason@post.harvard.edu.
Disclosure: Jason has been an expert witness in legal cases related to Cronobacter infection.
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