Caring for Our Childen (CFOC)

Chapter 4: Nutrition and Food Service

4.3 Requirements for Special Groups or Ages of Children

4.3.1 Nutrition for Infants

4.3.1.4: Feeding Human Milk to Another Mother’s Child

Content in the STANDARD was modified on 8/24/2017.

 


Because parents/guardians may express concern about the likelihood of transmitting diseases through human milk, this issue is addressed in detail to assure there is a very small risk of such transmission occurring.
 
If a child has been mistakenly fed another child’s bottle of expressed human milk, the possible exposure to infectious diseases should be treated just as if an unintentional exposure to other body fluids had occurred.
 
The early care and education program should (1):
 
a.  Inform the mother who expressed the human milk about the mistake and when the bottle switch occurred, and ask:
 
1.  When the human milk was expressed and how it was handled prior to being delivered to the caregiver/teacher or facility;
2.  Whether the mother has ever had a Human Immunodeficiency Virus (HIV) blood test and, if so, the date of the test and would she be willing to share the results with the parents/guardians of the child who was fed her child’s milk;
3.  If she does not know whether she has ever been tested for HIV, ask her if would she be willing to contact her primary health care provider and find out if she has been tested; and
4.  If she has never been tested for HIV, would she be willing to be tested and share the results with the parents/guardians of the other child.
 
b.  Discuss the mistake with the parents/guardians of the child who was fed the wrong bottle:
 
1.  Inform them that their child was given another child’s bottle of expressed human milk and the date it was given;
2.  Inform them that the risk of transmission of HIV is low;
3.  Encourage the parents/guardians to notify the child’s primary health care provider of the potential exposure; and
4.  Provide the family with information including the time at which the milk was expressed and how the milk was handled prior to its being delivered to the caregiver/teacher so that the parents/guardians may inform the child’s primary health care provider.
 
c.   Assess why the wrong milk was given and develop a prevention plan to be shared with the parents/guardians as well as the staff in the facility.

RATIONALE
Hepatitis B and C are not spread through breastfeeding (2,3).
 
The risk of HIV transmission from expressed human milk consumed by another child is believed to be low because:
 
a.  Transmission of HIV from a single human milk exposure has never been documented (1);
b.  Chemicals present in human milk stored in cold temperatures, act to destroy the HIV present in expressed human milk; and
c. In the United States, women who know they are HIV-positive are advised NOT to breastfeed their infants and to refrain from breastfeeding if they are hepatitis C-positive or have cracked or bleeding nipples. [However, the transmission of hepatitis C by breastfeeding has not been documented (4).
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
4.3.1.3 Preparing, Feeding, and Storing Human Milk
REFERENCES
  1. U.S. Centers for Disease Control and Prevention. 2016. What to do if an infant or child is mistakenly fed another woman’s expressed breast milk. http://www.cdc.gov/breastfeeding/recommendations/other_mothers_milk.htm.
  2. U.S. Centers for Disease Control and Prevention. 2016. Hepatitis B FAQs for the public. https://www.cdc.gov/hepatitis/hbv/bfaq.htm#bFAQ13.
  3. U.S. Centers for Disease Control and Prevention. 2016. Hepatitis C FAQs for the public. https://www.cdc.gov/hepatitis/hcv/cfaq.htm#cFAQ37
  4. American Academy of Pediatrics. Breastfeeding In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st Edition. Itasca, IL:  American Academy of Pediatrics; 2018: 113-114
NOTES

Content in the STANDARD was modified on 8/24/2017.