Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

TORCH

Posted by Laura on March 5, 2010

Most common infections of maternal origination to newborn are represented by the acronym TORCH. Until the infant is washed, Standard Precautions should be observed (gloves) for the safety of the caregiver, and in the case of HSV and neonatal infection of Pseudomonas aeruginosa – the infant.

T – Toxoplamosis disease caused by Toxoplasma gondii found in cat feces or raw meat of animals that graze on contaminated soil.  Clinical findings of a newborn many not be noted until later in life, but 85% will have mental retardation before 4 years old. This T is noted with preterm births, IUGR, Petechiae, fever and jaundice, as well as other serious mortality complications.

O – Stands for a grouping of ‘Other’. Other is:

  • Gonorrhea (Neisseeria gonorrhoeae)
  • Syphilis (Treponema pallidum)
  • Varicella (Varicella Zoster Virus)
  • Hepatitis B (HBV)
  • Human Parvovirus (Prvovirus B19)
  • Human immunodeficiency virus (HIV)

Breastfeeding with regards to HBV should be delayed until vaccination of the infant. Erythromycin off 0.5% is applied after birth to prevent ophthalmia neonatorum in the chance of Gonorrhea exposure, and neonatal conjunctivitis with Chlamydia trachomatis, to all infants. Infants born to HIV mothers are not recommended to breastfed.

R – Rubella (German measles or 3-day measles). Infants born with Rubella are isolated until non-contagious. Vaccination does not cross through mother’s breast milk, but mothers must sign informed consent and understand avoidance of pregnancy for 28 days due to teratogenic effects.

C – Cytomegalovirus (CMV) – Most common cause of congenital viral infection in the US. CMV can be transmitted through breast milk. Treatment requires careful monitoring because of the toxicity to the bone marrow.

H – Herpes simplex virus (HSV) – Babies of breastfeeding mothers can nurse as long as there are no lesions on the mother’s breast.

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