I am going to describe a very unique scenario and I am interested in other nurses thoughts and opinions.
An adoptive mom came in with a birth mom. Before delivery, adoptive mom explained that she had brought in pumped breast milk (from 2 of her very close friends who were nursing there own children) to feed the baby during the hospital stay. (For certain medical reasons, this mom could not produce her own breast milk, or she would have nursed the baby herself). The birth mom gave her verbal and written consent for this...included in the birth plan that she came in with. I, as the L&D nurse, did not have a problem with this plan. So, after delivery, adoptive mom fed baby the pumped breast milk.
When I went to visit both moms and the baby the next day, adoptive mom informed me that the entire postpartum floor was in an uproar, infection control had been notified, risk management involved, and she had been told that she could no longer feed the baby any of the pumped breast milk. After some time, staff allowed that if the 2 sources of breastmilk could come in and be HIV tested, they would allow adoptive mom to feed baby the pumped milk...maybe. The two friends did come in right away and since both had recently delivered at this very hospital, offered to have the staff look up their medical records (which included HIV results). By this time, moms and baby were ready to go home. Yes, they chose to leave after 24 hours. Home to a happy home with plenty of love and a freezer stocked full of donated breastmilk.
What would You have done.....and what would your hospital have done? Oh yeah.....someone is now researching this and coming up with a protocol.....like this scenario will ever happen again!
In my office I work for an OBGYN HIV testing is optional. In the hospitol it is mandatory but I think as a patient you have the right to refuse what will they do tell you to get out with a baby half way hanging out of you. It is your body and your choice to take an HIV test or to breast feed with other peoples milk. You are paying them big money they can treat you with respect. It cost about 12000 dollars to deliver at a hospital make sure your money is well spent.
In the several states I have worked in, HIV testing is opt out, meaning that written consent is not required, only refusal. However, HIV testing for the newborn was required if mom was not tested. If parents refused, DHS was called and took custody of the infant to consent to the testing. Scary, but mandated by law in a great many states.
It truly is a well meant law, vertical transmission is reduced immensely when prophylaxis is employed. However, that does not trump mom's right to bodily integrity or to consent on the behalf of her baby.
I think it is FABULOUS that this mom brought pumped breastmilk and totally ignorant on the part of the hospital. After all if the adoptive mom would have fed the baby at her breast she also would not have been HIV tested. It is possible for adoptive moms to feed at the breast but they need time to build a supply and not every mom will be able to build a full supply.
Boonce1
143 Posts
In my office I work for an OBGYN HIV testing is optional. In the hospitol it is mandatory but I think as a patient you have the right to refuse what will they do tell you to get out with a baby half way hanging out of you. It is your body and your choice to take an HIV test or to breast feed with other peoples milk. You are paying them big money they can treat you with respect. It cost about 12000 dollars to deliver at a hospital make sure your money is well spent.