My hospital requires Universal Precautions for handling EBM, fresh or
frozen.  I've shown our infection control people the Dec '92 letter from
OSHA giving their official opinion that EBM is not included in their
definition of "other potentially infectious bodily secrections".  Their
objection:  that letter is so old.  So I showed them the CDC statement of
Feb'01 that refers to and affirms the OSHA letter.  They rejected it out of
hand.  They KNOW that HIV & HepB are in EBM.  They KNOW that HIV can be
transmitted to baby thru his mother's milk, therefore they believe they are
at risk if a few drops of any mother's EBM on their fingers, even if washed
off quickly, is cause to start a round of HIV testing.  In our NICU, the EBM
is always frozen if brought in from outside the hospital, and fresh or fresh
refrigerated only if pumped in the hospital shortly before the next feeding.
The NICU RNs always glove before handling EBM.  Some even wear a thin yellow
coverall type robe over their scrubs.

I continually stated that I'm not trying to say they should never use Univ
Prec, just that their own cited authorities have published statements
contrary to their beliefs.  They've even cited JCAHO, saying that org
requires Univ Prec's for handling EBM.  I haven't seen that in writing.  Has
anyone else?

The NICU RN I was talking to about this recently did what the head of
Infection Control did, she shivered visibly at the thought of EBM on her
bare fingers.  When I described constant exposure as in a baby feeding every
2 hours or a milk bank worker handling & testing milk all day long, she did
not see that her handling of frozen thawed EBM every 2-3 hours in the NICU
for 2-3 babies as being any different.  To keep the peace, I told her again
I'm not trying to get anyone to stop using Univ Prec.  But I think I'm
somewhat on her "Whacko" list now.

This is a subject I will stay away from for a long time unless directly
asked.

Phyllis Adamson, IBCLC
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