In response to Susan's questions about breast milk and hospital policy
precautions...  I have recently worked with this in my acute care
children's hospital.  I provided the information from the CDC as well as
from HMBANA, ADA guidelines for infant feedings in hospital settings.
This is what I have found, what I have been explained by our Infection
Control RN Specialist.  No, human milk is not biohazard.  I am working
with changing policy as such.  No, human milk does not require special
handling as part of STANDARD PRECAUTIONS as noted in those previous
documents.  My understanding is that universal precautions have
overridden standard precations.  Maybe that varies from hospital to
hospital??  UNIVERSAL PRECAUTIONS does include breast milk as a body
fluid as well as blood and saliva. This is what the entire facility is
directed to adhere to.  What universal precautions is saying that there
is a POTENTIAL of any fluid to be contaminated.  Contaminated with what?
It does not matter.  It does not say that breast milk IS contaminated
but has the potential.  (examples could be - mother's blood from nipple
damage, viruses, bacteria).  Included with universal precautions is that
the health care worker will evaluate their risk to exposure and
determine what personal protective equipment they will use. My personal
examples would be:  if I am pouring breast milk from one container to
another, I dont feel that I will spill on myself and do not use gloves.
If I am working with mom and baby with a consult at breast, I do have a
glove if needing to touch nipple or oral exam, milk dripping etc...  If
a nurses aide is 'clumsy' and always spills things, she should choose to
wear gloves if she has risk of the milk pouring on her hands, it is her
elective.  I have received the approval to take off the biohazard
stickers from all freezers and refrigerators and replace with Human
Milk.  Analogy would be similar to changing an infant diaper.  If it has
stool in a small spot and containted within the inside of diaper, I will
wash my hands prior and after changing the diaper.  But if I think my
hands will become soiled wth stool because it is all over the diaper and
baby, I will wear gloves in addition to the handwashing. So, for our
institution, we feel it is covered within the hospital wide universal
precaution policy.
Anyone working on these issues, I say God Bless and Good Luck.  Angie
Kirkwood RN, BSN, IBCLC


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