This conversation is helpful to me.  I am ambivalent about exam gloves.  I always wash my hands first thing when I go to a consult.  I try to be very conscious of not touching my own person after washing my hands.  I wear nitrile gloves when I do an oral exam or touch a mom's breasts if she has damaged tissue.  I am not protecting myself, I am trying to protect the mom/baby from my germs.  I feel like I am not especially vulnerable to infection but the baby and mom may be.

I also wash my gloved hands thoroughly before considering the gloves clean enough to use on mom or in baby's mouth.  The gloves are not sterile and I wouldn't want them in my baby's mouth so I wash them before using in a client's baby's mouth.

I also do not think that vinyl exam gloves are appropriate for use in a baby's mouth.  Vinyl contains plasticizers that concern me.  I wouldn't let my baby chew on a vinyl toy and I wouldn't use a vinyl glove in my baby's mouth.  Nitrile is more expensive but I think it is the best of the options.

If I could be sure my clean hand was okay for an oral exam, in consideration of the baby's safety, I would prefer this to the gloves.  It also makes me sad to think that I may be conveying the message that something is wrong with the mom if I wear gloves.  I will be sure to tell moms exactly why I am wearing them in the future.  I usully do this but now I will try to always do so.

Laura Spitzfaden LLLL, IBCLC

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