To most, hoses, flanges, valves and connectors sound like things you'd find under your car's hood. But new moms only have to glance down to see these breast pump parts in action.
With all the tiny pieces, understanding how to clean a breast pump can be tricky, so the Centers for Disease Control and Prevention (CDC) issued breast pump cleaning guidelines to help parents clean pumps as well as possible. The guidelines suggest pump parts should be cleaned quickly after each use in either a dishwasher or a basin used only for baby things (not the kitchen sink), air dried and then sanitized.
These strict guidelines were met with incredulity upon release last year—as many working, pumping mothers have to make do with a quick wipe down or stash their pump in the fridge at work between uses—but the CDC means well.
The strict sanitation standards were developed after a prematurely born baby contracted a terrible illness from a breast pump left in the sink too long. "We reviewed existing resources for women about how to pump breast milk safely," said Dr. Anna Bowen, CDC medical officer, in email comments to Motherly when the guidelines were initially released. "We found little guidance that provided a lot of detail and was based on the best available science. As a result, CDC developed its own guidance."
The baby girl developed an infection at 3 weeks old, and when testing revealed the very uncommon Cronobacter sakazakii in her spinal fluid, the CDC went looking for the source and found it in frozen milk samples from the mother's personal pump, as well as on the pump itself and on the drain of the mother's kitchen sink.
The mother told the CDC she would clean her pump by placing the parts in a sink full of soapy water for hours before rinsing and air-drying all the parts. The parts were neither scrubbed nor sanitized, prompting the CDC to issue the guidelines.
The agency meant to protect babies and help parents, but the guidelines stoked panic and, in some cases, anger, in working moms who could not possibly follow them.
We reached out to Mark A. Underwood, Chief of Pediatric Neonatology and Professor of Pediatrics at the UC Davis School of Medicine.
He told Motherly the new CDC breast pump guidelines may not be helpful for moms supplying for healthy, full-term babies: "My advice is to find a sustainable approach that fits a mom's circumstance."
According to Dr. Underwood, the CDC and FDA create guidelines like those this case sparked to protect the largest number of babies from the worst possible outcomes—but not all babies require extreme levels of sanitation.
Dr. Underwood explained following the CDC guidelines is prudent for mothers pumping for premature babies or those with immune deficiencies, but other moms can relax. He said, "If she is pumping for a healthy term infant this level of detail to cleaning and sterilizing equipment may not be helpful."
While the cautious approach outlined in the CDC guidelines is designed to minimize the risk of infection, Underwood says the flip-side of the coin is the evidence that too much sanitation is actually harmful for most healthy babies. "[It] can increase risk of allergic and autoimmune diseases later in life," he says, adding that studies that have shown fewer incidents of allergies, asthma and inflammatory bowel disease in children raised on farms and in children raised without dishwashers.
We also reached out to the CDC for clarification on how the new guidelines should apply to working moms of healthy babies.
"Refrigerating used pump parts between uses might be OK if the pump kit is not contaminated," Brittany Behm, Public Affairs Specialist for the CDC said in an statement emailed to Motherly. "But cleaning the pump kit after each use is the safest method and is particularly important for babies who are younger than 2 to 3 months old, were born prematurely or have weakened immune systems."
Behm also discouraged the use of breast pump sanitizing wipes, which she said cannot adequately reach all the surfaces of pumps. Instead, she said cleaning the parts in a dishwasher or by hand is the CDC's preferred post-pump sanitizing method.
She also expressed hope that workplaces will respond to the new guidelines with better options for pumping mothers. She said, "Ideally, workplaces would provide facilities and support for mothers to safely pump and store their milk."
Unfortunately, that's not reality for many of us—but working moms of healthy babies can take comfort in Dr. Underwood's advice and just do the best we can with what we've got.