Handwashing is the most effective way of preventing the spread of disease. To
be effective the hands must be washed with soap and water for one to three
minutes. The use of friction is important also important. Even if useing
gloves it is still important to wash your hand before and after each contact.
 Universal Precautions are now the law in the United States. As of July 1992
employers can be fined up to $70,000 for nonenforcement of the law. As a
health care worker, the lactation consultant is also subject to this law.
Universal precautions require the health care worker to assume the potential
for infection (Hepatitis B, HIV and other bloodborne pathogens) exists in
every client contact. When universal precautions are not used, the consultant
can become infected, she can infect the client and/or cross contamination
between clients can occur. Adequate personal protection is required when
there is any possibility that contact with body fluids might occur. These
fluids include: all undifferentiated body fluids, blood, semen, vaginal
secretions, amniotic fluid, salvia, any fluid that appears bloody, and
breastmilk. It is therefore necessary to wear latex gloves when there is a
probability that  contact with body fluids will occur. For the lactation
consultant, this includes contact with: mother's bleeding nipples, urine,
stool, breastmilk, and/or the baby's oral surfaces.
 Please consider the issue carefully. This is not an HIV issue alone.
Hepatitis is easier to catch than HIV and it is more common. You can't tell
if someone is a carrier of any disease by just looking and people don't
always volunteer information. You don't want to give anything to the mom just
as much as you don't want to catch anything from her.
It took a long time for nurses to accept universal precautions because they
felt it diminished human contact and made care seem impersonal. (Like we were
treating people as if they had cooties.) Hepatitis used to be considered an
occupational hazzard for nurses. Most hospitals now require nurses to get
immunized for hepatitis B.

Marie Davis, off the soapbox for now.