I wash my hands for a full minute prior to doing exams (I do home visits
exclusively.)  However, I don't carry a nail brush, and it is the germs that
can hide in nail beds that worry me.  I use non-powder, non-latex gloves and
wear them to protect mother and baby from the germs I may carry in.  I wear
the gloves while doing breast exams and if I examine the baby's mouth.

There is another  issue involved.  Sometimes the mother I have come to help
is home alone.  I am a stranger, touching her on an intimate part of her
body.  In a way, the gloves are somewhat 'distancing'.  They sometimes help
to create a sort of psychological barrier for the exam that makes it less
threatening in some way.  If the nipples are not cracked and once I am
through checking the baby, I usually take them off.  By then, I've created
some rapport with the mom and do not feel like such a stranger to her.

I also wipe down my scale in front of the mom with a bleach wipe.  If I were
a new mom and a total stranger were coming into my home, I'd want to see her
wash up and use all care to not expose the baby to anything.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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