Question for m/b/nursery RN's

Specialties Ob/Gyn

Published

I work in a nursery and have a few questions regarding handling

breastmilk, changing infant diapers, feeding. Most of our RN's do not

wear gloves for these things :eek:. What is recommended?

I know that intact skin is a great barrier to any infectious disease, but should our

confidence be based soley on that belief or should our RN's routinely

wear gloves for these activities? Most of our pregnant women are tested

prenatally and we have an idea of their HIV status at an early

gestation, however things can happen during the rest of the pregnancy.

Many of our nurses get their confidence from this early testing alone as

well as presence of other high risk behaviors. What is best practice?

OSHA has guidelines in regards to all bodily fluids, but most of our nurses to do not follow these guidelines when it comes to working in the nursery. There are a few nurses who wear gloves and a few that have made statements like, " I wear gloves for all contact with breastmilk. We wash our hands a lot and breastmilk can contain HIV and you never know if you have small cuts in your skin from washing so much. " Is this comment over the top or is it in line with what most nurses believe.

Want to start a good discussion :)

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Specializes in Community, OB, Nursery.

Moved to Ob/Gyn forum for discussion :)

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Specializes in Reproductive & Public Health.

I have worked in OBGYN for about ten years and I am amazed at the differences in UP that I see among practitioners. I have actually seen people deliver babies (in a home setting) without gloves! Infection risk aside, that is just MESSY!!!

I wear gloves for anything that involves bodily fluid, for my protection and for the clients' protection. Especially those newborn babies- they don't need my hospital germs all over their fresh new skin. And if I am helping a new mother breastfeed, I don't want my fingernails to come into contact with her nipples- I could be carrying yeast under my fingernails for all I know! Despite my best handwashing practices, I don't want to chance it.

On the other hand, there is the human aspect to it, where you want to be able to *touch* someone without a glove. Especially in L&D, that human contact can make a world of difference. But if there is blood, fluid, etc- I want us all to be protected.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

The only time I wear gloves with regards to baby care is before their first bath, when drawing blood, or when allowing the baby to suck on my finger.

I don't wear gloves for diaper changes. Some of the nurses do wear gloves for handling breastmilk, but I do not (I'm an LC and have breastfed three, so breastmilk doesn't squeag me out the way it does with some other nurses).

Don't know what to tell you. I know it probably goes against OSHA and everything we've learned in nursing school.

When I was in labor with my last baby, the OB let my husband deliver him (meaning, OB was completely hands off and just verbally walked my husband through it). I remember as I was pushing and starting to crown, and I realized my husband wasn't wearing any gloves. I freaked out and told him to get some gloves on NOW! You never touch a fresh gooey baby without gloves, I don't care if it's your own! LOL

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Our hospital policy is to wear gloves when handling breast milk (because it's a bodily fluid), and changing diapers (also bodily fluids). When bottle feeding formula, gloves are not necessary, but if feeding pumped or donor breast milk, gloves are required.

Gloves are also necessary if handling a baby who has not had its first bath yet and when assisting a mom to latch the baby on - she may have traces of milk on her skin, or if her nipples are cracked, the nurse could create an infection.

I couldn't tell you if every nurse on the unit adheres to policy, though...

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