NEBGH Member Cara Pensabene, MD shares important things to know on breastfeeding in the workplace and Necrotizing Fasciitis
In the U.S. about 8 out of 10 new mothers go with the “Breast is Best” mantra and choose to breastfeed their babies from birth, according to the Centers for Disease Control. More than half of those babies are still being breastfed at six months, which is great news since the American Academy of Pediatrics recommends exclusively breastfeeding during these critical months of development. August is National Breastfeeding Month, which is a campaign created specifically to elevate awareness of the importance of breastfeeding and the necessity of support for breastfeeding mothers. For many new moms, breastfeeding and returning to work is particularly challenging.
In a call to action published by the Surgeon General titled “Barriers to Breastfeeding” published in 2011, several different barriers were examined that often inhibit a woman’s ability or desire to commit to breastfeeding their infant children. One of those barriers mentioned was employment. There are several reasons employment can be a barrier, including:
- Lack of flexibility in work schedules
- No place to keep expressed breastmilk
- Lack of privacy for either breastfeeding their child or using a pump to express milk
Most workplaces do not allow mothers to bring their infant children to work with them, and childcare facilities are rarely on-site. Plus, existing break allotments simply aren’t long enough to allow for breastfeeding or expressing milk. All of this adds up to making it very hard on the mother to continue her choice to breastfeed.
In light of the importance of breastfeeding and that employment can be a barrier, many employers have taken the initiative to support breastfeeding moms when they do return to work. Some states have actually started introducing laws about how employers should support breastfeeding mothers. For example, in the state of Texas, there are Texas Mother-Friendly Worksites, which means the worksite offers:
- Access to a private lactating space other than a restroom
- Access to a portable cooler or refrigerator where the milk can be stored
- Flexibility in scheduling to allow for breaks for milk expression
- Access to a sink to wash hands and breast pumps with clean water and soap
The advantages are actually quite clear. For every $1 invested in breastfeeding support business owners have the potential to garner a $3 return on their investment. Lower rates of absences, increased employee morale and retention, and even better productivity are possible advantages for businesses, according to the Office On Women’s Health.
Necrotizing fasciitis (NF), better known as flesh-eating bacteria, has been making a lot of headlines this year. There have been cases covered that occurred on the pristine ocean beaches of Florida, the picturesque lakes in Kentucky, and even in pools. Some travelers have altered their vacation plans and avoided beaches altogether this summer, but is NF as scary and as prevalent as it sounds? Here’s what you need to know.
What exactly is necrotizing fasciitis?
The Centers for Disease Control gives the definition if necrotizing fasciitis as:
“…a rare bacterial infection that spreads quickly in the body and can cause death.”
Even though NF is often referred to as a “flesh-eating” bacteria itself, NF is actually the result of a person contracting a bacterial skin infection. There are multiple types of bacteria that can cause NF, including group A strep. But, the form of bacteria getting the most attention recently for causing necrotizing fasciitis is Vibrio vulnificus, which is naturally present in warm coastal waters.
What are the dangers of necrotizing fasciitis?
NF is super scary because it spreads quickly and causes tissue to die rapidly. The earliest symptoms of NF include an area of skin that is swollen and red with pain that seems far deeper than just pain in the irritated area. Fever is also common. If these early symptoms are spotted, it is critical to get immediate medical attention because the condition can progress really fast. The condition kills the tissues so quickly that it can be difficult for antibiotics to get into the tissue and get to work because there is little or no blood flow present. In these cases, the dead tissue has to be removed promptly to prevent the condition from spreading. One in three people will actually die from an infection that results in NF due to common complications like shock, sepsis, and organ failure.
So, how big is the problem really?
So far in 2019, there have been reports of NF in several states – including Texas, Alabama, Florida, Delaware, and California. The CDC estimates about 205 cases of vibrio vulnificus NF infection this year – which is on the rise from years past because of climate change. A study published in the Annals of Internal Medicine said that rising water temperatures in the Delaware Bay may be to blame for an increase in the number of infections in these previously rarely affected waters. The authors of the study reported five cases of Vibrio vulnificus NF that occurred during the summer of 2017 and 2018. In the eight years before 2017, only one case of infection had been previously reported.
How easy is it to contract necrotizing fasciitis?
NF develops when an open wound comes in contact with coastal saltwater that contains vibrio vulnificus or other bacteria. While anyone can get NF, it is pretty rare and not considered to be contagious. Most people who get this condition have a compromised immune system or underlying medical illness that lowers their body’s ability to fight infections, such as liver disease and diabetes.
Should everyone be protecting themselves from necrotizing fasciitis?
Most cases of infection occur between May and October, when coastal waters are the warmest. To protect yourself from exposure, make sure you stay out hot tubs, swimming pools, and natural bodies of water if you have an open wound, especially if you have one of the aforementioned medical conditions that can make you more prone to infection. Likewise, wear protective footwear and be careful not to cause scrapes or abrasions while swimming in salty and brackish waters. If you get wounded in the water or realize you have a wound after getting in, wash the wound with a good antibacterial soap and always watch out for signs of an infection.