My (edited) response to Judith.
Judith:
I don't believe your information is correct: it would be extremely unusual to
test a mother's milk for CMV and herpes 1 & 2 - I believe you mean the
mother's serum was tested and positive for CMV and herpes 1 & 2. Also, herpes
has NEVER been reported as cultured from human milk - even with herpes on the
breast.

You should already have, as part of your NICU standards of care, a procedure
for what to do if the wrong milk is given to a baby.  Call the Sharp Mary
Birch lactation consultant on call for the NICU (XXX-XXX-XXXX) and have her
paged, and ask her to fax you the SMBHW procedure.

Was the milk fed fresh or frozen?
Herpes is NOT transmitted through breastmilk - but through skin contact.
CMV is transmitted through breastmilk, but the risk is almost 0 with only 5
cc, and even more unlikely if the milk was previously frozen.  IF the infant
was infected with CMV via the breastmilk, he will not test positive for CMV
by PCR for 3-6 weeks (earlier by PCR than urine culture positive).  At 34
weeks the infant , if infected, should not show any signs of illness or long
term sequellae.  In order to show that the CMV was from the breastmilk and
not his biological mother, you would have to test his mother for CMV as well
to show she is negative.  Early CMV exposure in babies > 32 weeks is actually
a GOOD thing- reducing the occurance of later congentital CMV in the
population.

Yes, the charge nurse or nursing manager needs to report this occurance to
your risk management team.  I assume this was a nursing error and not a
lactation consultant who independently fed the wrong milk to the infant.  The
mother whose milk was given to the baby will need to be tested for HIV, if
she wasn't tested prenatally.  The AAP "Red Book" is a good place to look for
information on any infectious disease.  There is also an entire chapter on
human milk.

I would be happy to talk with the Neonatologist.  With so many mothers
pumping milk for their NICU infants, the wrong milk is given occassionally to
the wrong baby in EVERY NICU.  Breastmilk contains so many ant-infective
factors that there has never been a report of cross-infection with accidental
feeding of small volumes of milk.
Nancy
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA

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