Hello wise ones, and happy holidays!

I work as a lactation consultant in a hospital. I'm currently working with our hospital's infection prevention and control department to put together hospital guidelines on what to do when one baby is accidentally fed milk expressed by another mother. I've looked to groups like the Centers for Disease Control and Prevention, the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, the Human Milk Banking Association of North America, and the California Perinatal Quality Care Collaborative for recommendations or sample policies. I've also looked online for other hospitals' policies and searched the Lactnet archives. From the information that I've found so far, there doesn't seem to be a consensus as to how blood testing should proceed. My specific questions are: 

1. Who should undergo blood tests---the mother who expressed the milk, the mother of the baby who received the milk, and/or the baby who received the milk?
2. What blood tests should be performed? The CPQCC Nutrition Toolkit from 2008 recommended testing all source mothers for HIV 1 and 2 antibody, hepatitis C antibody, and hepatitis B surface antigen, and also testing for HTLV 1 & 2 antibody, syphilis (RPR or VDRL) and CMV antibody on a case-by-case basis. Meanwhile, the 2016 CDC guidelines on "What to Do if an Infant or Child is Mistakenly Fed Another Woman's Expressed Breast Milk" make reference to "HIV or other infectious diseases," but only discuss testing for HIV. Are the CPQCC guidelines from 2008 still the ones to go by?
3. What sort of follow-up testing is needed? Is it still standard practice to recommend follow-up testing for HIV, hepatitis B, and hepatitis C at 3 months, 6 months, and 1 year?

Thank you for any help that you can provide, and for any sample guidelines that you can share!

Sincerely,
Lisa Lostetter, RN, IBCLC
Albuquerque, New Mexico, USA

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