Perhaps day-care workers should have seen this one coming. With AIDS on the increase and everyone from dentists to basketball coaches wearing gloves so as not to touch blood - it was just a matter of time before health professionals turned attention to another formerly benign body fluid - breast milk.
A recent Knight-Ridder article quoted several East Coast health experts advising day-care workers to wear gloves when handling bottles of expressed mother's milk.Wearing gloves to feed baby? Utah health-care and day-care workers seemed surprised by the suggestion. Edie Sidle, HIV program director for the Utah State Department of Health, said, "Wow. Wow. This is the first time I've ever heard of that being such a major concern."
Sidle did some research and found no incidence of anyone ever getting AIDS from touching breast milk. She said infants born to HIV-positive mothers only have a 25 to 30 percent chance of testing positive themselves. If they drink breast milk, the risk of transmission only increases by 10 to 20 percent, says Sidle.
And, she points out the benefits of breast milk are so great that the World Health Organization is advising HIV-positive mothers in developing countries to continue to nurse. Their children have a much higher risk of contracting other diseases or of dying of malnutrition if they aren't nursed. (In developed countries where formula is available, mothers are advised not to nurse.)
So if the risk from drinking the milk is low, Sidle believes the risk of touching breast milk would be practically nonexistent. She cites a study in Denver of police officers who were either bitten by or had broken skin when they were bled on by HIV-positive people. Out of more than 140 incidences of risk, not one officer tested HIV positive. A person with no open wounds should run no risk at all from touching breast milk, Sidle believes.
Dr. Susan Aronson is a pediatrician who helped develop the child-care policies for the Pennsylvania Chapter of the American Academy of Pediatrics. In the Knight-Ridder article she is quoted as saying, "Unfortunately, as wonderful as breast milk is, it is a body fluid. I always explain this with great regret. It falls clearly under the requirements for handling body fluids."
Sidle checked with the Centers for Disease Control and Prevention in Atlanta, which has issued no specific recommendations about breast milk. Although the American Academy of Pediatrics is a well-respected organization, this was just a recommendation from one chapter, Sidle points out. She says Utah officials would wait to hear from OSHA or the CDC, or some similar agency before drawing up new guidelines.
In Minnesota and Washington D.C., as well as in Pennsylvania, some day-care center workers wear gloves to feed babies, not because the health departments have required them to but because nurses who have drawn up the guidelines for the day-care workers are advising them to.
JoEllen Robbins, director of Professional Child Care Inc. center in Salt Lake City, says 99.9 percent of the time a child-care worker's hands never come in contact with breast milk. They already handle it carefully to avoid the risk of contaminating the milk. Robbins says she would be more likely to get milk on her shirt or neck, from burping a baby, than she would on her hands.
Two years ago, when they were instructed to wear gloves when changing diapers, she and the other care-givers adapted easily to the new requirement. "Our biggest concern there is hepatitis. If we got it on our hands we could transfer it to another baby." About AIDS, Robbins says, "I'm not a fearful person. But if the state department told me to wear gloves, I'd do it. It's part of my job."