Inadvertent breast milk exposure: Difference between revisions
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* Women often pump breast milk for neonates in hospital, and mix-ups occasionally happen |
* Women often pump breast milk for neonates in hospital, and mix-ups occasionally happen |
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* Risk of infection is low, but includes [[Hepatitis B virus|hepatitis B]], [[Human immunodeficiency virus|HIV]], and [[Human T-lymphotropic virus|HTLV]] |
* Risk of infection is low, but includes [[Hepatitis B virus|hepatitis B]], [[Human immunodeficiency virus|HIV]], and [[Human T-lymphotropic virus|HTLV]] |
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== Investigations == |
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* From donor mother, send the following: |
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** HBsAg, stat |
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** HIV serology, stat |
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** HCV-Ab |
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** HTLV serology |
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** CMV serology (if the recipient baby is less than 32 weeks old) |
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* If the donor mother is positive for any of the above, also test the recipient's mother |
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== Management == |
== Management == |
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* Inform infection control, nurse manager, etc. |
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* Investigations as above, and management as below |
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{| class="wikitable" |
{| class="wikitable" |
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! Donor mother !! Recipient mother !! Suggested management |
! Donor mother !! Recipient mother !! Suggested management |
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| HIV positive || Continue standard prophylactic therapy |
| HIV positive || Continue standard prophylactic therapy |
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* If given, HBIG should be given within 24 hours and vaccine within 7 days |
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* If given, HIV prophylaxis should be started within 1 to 2 hours of exposure, but can be started up to 48 hours later |
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[[Category:Infection_prevention_and_control]] |
[[Category:Infection_prevention_and_control]] |
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Revision as of 01:27, 13 November 2019
- Women often pump breast milk for neonates in hospital, and mix-ups occasionally happen
- Risk of infection is low, but includes hepatitis B, HIV, and HTLV
Investigations
- From donor mother, send the following:
- HBsAg, stat
- HIV serology, stat
- HCV-Ab
- HTLV serology
- CMV serology (if the recipient baby is less than 32 weeks old)
- If the donor mother is positive for any of the above, also test the recipient's mother
Management
- Inform infection control, nurse manager, etc.
- Investigations as above, and management as below
| Donor mother | Recipient mother | Suggested management |
|---|---|---|
| Hepatitis B | ||
| HBsAg negative | HBsAg negative | Routine immunization for hepatitis B |
| HBsAg positive | Administer hepatitis B vaccine and immune globulin (HBIG), if not yet given | |
| HBsAg positive | HBsAg negative | Administer hepatitis B vaccine, if not yet given, and HBIG |
| HBsAg positive | Administer hepatitis B vaccine and HBIG, if not yet given | |
| HIV | ||
| HIV negative | HIV negative | Routine care |
| HIV positive | Continue standard prophylactic therapy | |
| HIV positive | HIV negative | Could consider zidovudine in high-risk situations, though no routine recommendation |
| HIV positive | Continue standard prophylactic therapy | |
- If given, HBIG should be given within 24 hours and vaccine within 7 days
- If given, HIV prophylaxis should be started within 1 to 2 hours of exposure, but can be started up to 48 hours later
