At 06:15 PM 11/25/2003 -0500, you wrote:
>This is such a good question. It just came up at our last staff
>meeting but we never decided on the best answer. We all carry finger cots
>on home
>visits. I always wash my hands immediately before handling the baby then
>ask if
>the parents would prefer I wear a cot if I am doing an oral exam.

>One of our consultants

that would be me! :-)

>brought up the point that the cots are latex and this could be
>quite a problem if there was a latex allergy.  We debated about using nonlatex
>gloves but we all feel the bare hands are better too.

actually, i will clarify my own perspective on this - I feel bare hands are
best for the general consultation, but for an oral exam, and sometimes the
breast exam, i always use a non-latex glove.  I was trained using finger
cots, and i do have some on hand, which I have been known to use, with
permission, when I didn't have a glove for some reason.  In general though,
I use the glove, simply because of the latex issue.  Once, before I
switched to primarily the non-latex gloves, I was about to use a finger cot
when I thought to ask the mom about allergies (hadn't gotten to that part
of the intake yet).  She said "Oh, no - just latex.  *Severely* allergic to
latex."  I was so glad I had asked at that very moment!  Since then I am
much more leery of the cots.

>Does anyone else use the
>cots? What about this Latex allergy question? Also, do you think it is okay to
>ask the parents permission to not use any gloves at all?

In my opinion, that would be opening oneself up to possible
scrutiny/liability, in the event that the consult goes badly, the parents
are not satisfied with the outcome, the baby has troubles later on that
could be related to possible infection, etc. etc. etc.  As BWC mentioned,
even demonstrating in front of the mother how we manage infection
control.  I can definitely imagine a new parent wondering about those
things but being too embarrassed to ask.  I have had similar
worries/concerns at the dentist before I got up the nerve to ask the
questions that were nagging at me.  So if our practices and our words
demonstrate our awareness of these issues to new parents, then they won't
have to worry *or* ask.


Lyla Wolfenstein, B.S., IBCLC, RLC
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