A few weeks ago, after looking to sites like the CDC (Centers for Disease Control and Prevention), HMBANA (the Human Milk Banking Association of North America), and the CPQCC (the California Perinatal Quality Care Collaborative) for guidelines on what to do when one baby is accidentally fed milk expressed by another mom, I posted some specific questions to Lactnet seeking clarification on how blood testing should proceed after these situations occur. I received several responses, both on the list and privately. Many thanks to those of you who responded. Your responses were very helpful to me as I worked to create milk misadministration guidelines for the hospital where I work.

From the research, recommendations, and sample policies that I've seen, there really doesn't seem to be a consensus as to who should undergo blood tests (the mom who expressed the milk, the mom of the baby who received the milk, and/or the baby who received the milk). There also doesn't seem to be a consensus on what blood tests should be performed, or when follow-up blood tests should be performed. The CPQCC guidelines from 2008 recommend testing the mom who expressed the milk for HIV, hepatitis B, and hepatitis C, and also, depending on the circumstances, for HTLV 1&2, syphillis, and CMV. The CPQCC guidelines then recommend re-testing for HIV, hep B, and hep C at 3 months, 6 months, and 1 year. This is the blood testing regimen that will likely be adopted at my hospital. 

Pat Young, I agree with you that it would be very helpful for a group like the Academy of Breastfeeding Medicine to put out clear-cut guidelines on this topic.

Again, my thanks to all of you who so generously shared your knowledge and expertise. I am very grateful for this group!

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

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