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RN has question about breast milk exposure

Jul 31, 2005

I love this site and your help with tough issues regarding HIV and STDs. I think you're doing a great service to the many men and women concerned about these issues.

I'm a NICU RN. Two days ago I was mixing up breast milk in a 30 cc syringe with human milk fortifier for NG feeding. I put the plunger in the end of the syringe and was shaking it up and mixing it. I had my finger on the other end and it created suction. When I let my finger off the end of the syringe it sprayed me in the face and arms. I'm worried b/c I'm not absolutely certain about whether or not it got in my eye b/c I blinked right at the time that it got on my face since it startled me. I know it was on my cheek and my glasses b/c I took them off and saw minute specks on them from the breast milk. I reviewed the mother's prenatal labs and they were all negative including HIV, except she had been treated prenatally for chlamydia and her most recent cx was neg.

Ok, assuming that she contracted HIV during pg after the labs had been drawn and the breast milk did get in my eyes (which would have been an incredibly small amt) what are my risks for HIV?

I went to Occ Hlth and the RN down there said that breast milk was a poor transporter in small quantities for HIV and that they don't even test for that unless it is given to the wrong baby (yikes) which has actually happened before and that's just b/c you're talking about significant amts consumed. She said she saw no reason to test me or the mother and she thinks that if I got it in my eye I would have absolutely known. As I said I can't be certain as to whether I did or didn't as I blinked but I know it wasn't a large amount like when you get a drop of sweat in your eyes. You absolutely know when something like that happens. It would have been a speck b/c that's what was on my glasses.

Do you concur with what the Occ Hlth nurse told me? Please let me know. Do you think I should test myself after 12 wks?

Thank you so much.

Response from Dr. Frascino

Hello NICU RN,

I'm glad you reported the incident to occupational health. That's exactly what all health care providers should do in cases of potential occupational exposure. I'm also delighted to see that occupational health gave you correct information about your potential exposure. I agree testing is not warranted.

Did you know that in addition to being a board-certified immunologist, I am also a board-certified pediatrician? I have many fond memories of all the dedicated nurses in the neonatal intensive care units that helped me during my pediatric internship and residency. On behalf of all the struggling adorable little premies, (and the struggling interns and residents rotating through the NICU) thank you for your loving care.

Stay well.

Dr. Bob

To test or not to test or not to test or not to test or not to test or not to test ...
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