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Blood cultures contaminated with skin flora during collection are common but contamination rates should not exceed 3%. Laboratories should have policies and procedures for abbreviating the workup and reporting of common blood culture contaminants (eg, coagulase-negative staphylococci, viridans group streptococci, diphtheroids, Bacillus spp other than B. anthracis ). These procedures may include abbreviated identification of the organism, absence of susceptibility testing, and a comment that instructs the clinician to contact the laboratory if the culture result is thought to be clinically significant and requires additional workup and susceptibility results.

Physicians should expect to be called and notified by the laboratory every time a blood culture becomes positive since these specimens often represent life-threatening infections. If the physician wishes not to be notified during specific times, arrangements must be made by the physician for a delegated healthcare professional to receive the call and relay the report.

Key points for the laboratory diagnosis of bacteremia/fungemia:

Volume of blood collected, not timing, is most critical.

Disinfect the venipuncture site with chlorhexidine or 2% iodine tincture in adults and children >2 months old (chlorhexidine NOT recommended for children <2 months old), using povidone-iodine and alcohol).

Draw blood for culture before initiating antimicrobial therapy.

Catheter-drawn blood cultures have a higher risk of contamination (false positives).

Do not submit catheter tips for culture without an accompanying blood culture obtained by venipuncture.

Never refrigerate blood prior to incubation.

Use a 2- to 3-bottle blood culture set for adults, at least 1 aerobic and 1 anaerobic; use 1–2 aerobic bottles for children and consider aerobic and anaerobic when clinically relevant.

Streptococcus pneumoniae and other gram-positive organisms and facultatively anaerobic organisms may grow best in the anaerobic bottle (faster time to detection).

The diagnosis of catheter-associated BSIs is often one of exclusion, and a microbiologic gold standard for diagnosis does not exist. Although a number of different microbiologic methods have been described, the available data do not allow firm conclusions to be made about the relative merits of these various diagnostic techniques [ 10–12 ]. Fundamental to the diagnosis of catheter-associated BSI is documentation of bacteremia. The clinical significance of a positive culture from an indwelling catheter segment or tip in the absence of positive blood cultures is unknown. The next essential diagnostic component is demonstrating that the infection is caused by the catheter. This usually requires exclusion of other potential primary foci for the BSI. Some investigators have concluded that catheter tip cultures have such poor predictive value that they should not be performed [ 13 ].

Ifbleeding carries on after baby is a week old or if bleeding happens at a later stagethan the first week, continue breastfeeding but always check with your doctor (Newman, 2014).

If the cause of blood in breast milk is due to a mother’s cracked ordamaged nipples, it is important to find the cause of the damage so the nipples can heal. See our article on causes of sore nipples or contact your IBCLC lactation consultant for help with Frill Cover Up Jacket Red pattern New Look Buy Cheap Visa Payment O3tDK
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your newborn baby.

Breast damage from rough handling such as pressing too hard during hand expression or using a pump with a very high vacuum could cause bleeding from broken capillaries (tiny blood vessels) as they are very delicate.

An intraductal papilloma is a small growth in the lining of a duct near the nipple. It is usually noncancerous and doesn’t cause pain

Fibrocystic breasts is the name used for a group of symptoms in the glandular breast tissue including breast pain, solid lumps and cysts. Breastfeeding A Guide for the Health Profession discusses that fibrocystic breasts are a cause of a discharge of blood from the nipple in pregnancy and lactation in approximately a third of cases but it is not a contraindication to breastfeeding. The authors mention one case where fibrocystic breasts were found to be the cause of an infant vomiting due to the volume of blood in breast milk.

Jack Newman, Canadian paediatrician and breastfeeding expert says that although blood will cause a baby to spit up more, breastfeeding can continue. He explains:

Taking the baby off the breast is often suggested if the mother’s nipples bleed from a crack or abrasion. But blood in the milk is not a reason to take thebaby off the breast. The issue is the pain the mother feels, not the blood. Blood in the baby’s stomach can cause spitting up but is not dangerous. If we can make the mother’s pain tolerable, even if the nipples continue to bleed, let’s keep the baby on the breast. If the damage is minimized by fixing the way thebaby takes the breast, the abrasions/cracks will heal and the bleeding will stop.

Breastfeeding author and lactation consultant Nancy Mohrbacher Breastfeeding Answers Made Simple , 2010, p 702 agrees that it is OK to continue breastfeeding and that the bleeding will not be harmful to the baby.

If your baby has drunk a lot of blood stained breast milk they might have very dark coloured poop or may spit up very blood-stained milk. The blood can form a large clump in the stomach and this might look like a lot of blood when spit up— always check with your health professional for immediate medical advice

always check with your health professional for immediate medical advice

Your health professionals will be able to determine whether the blood is from baby or the breastby checking the regurgitated blood for foetal or adult haemoglobin

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