In the US, exposure takes two forms.  One, milk gets on the hands of the RN
or other staffer who is defrosting, warming & feeding EBM to a baby.  Two,
the EBM of one baby is mistakenly fed to a different baby.

For the first, in my hospital, despite clarifications by OSHA and the CDC
that human milk is not included, in their official opinions, in the category
of "other potentially infectious bodily secretions", all RNs prefer to wear
gloves for their own protection from their perceived risk of catching HIV or
HepB from this fresh or defrosted EBM.  Some even wear those thin yellow
coverall robes over their scrubs when handling the EBM.  They see no
difference between themselves feeding 2 or 3 NICU babies and the milk bank
worker who is handling EBM all day long for 8-10 hours.  A milk bank worker
does use universal precautions both for their own protection and for the
protection of the milk from the worker.  The concept of protecting the milk
from the worker does not compute amone RNs in my hospital.

For the second, if the mother who produced the milk refuses to take an HIV
test, there is nothing the hospital, or the mother of the recipient baby,
can do to make her take the test.  So the hospital worries about liability,
and the second mother worries for years about the "bad" milk being fed to
her baby.

Phyllis Adamson, IBCLC
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