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Right bottle, wrong infant

I recently started work on a maternity unit, where I often help new mothers learn to feed their infants. In some cases, mothers are bottle-feeding previously expressed breast milk. If a mother is inadvertently given another mother's bottled breast milk to feed her infant, is any harm done?-J.J., ME.

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According to the CDC, exposure to the wrong breast milk carries a small risk of HIV transmission. Consequently, a child's exposure to another infant's bottle of expressed breast milk should be treated like any other accidental exposure to body fluids. Follow your facility's policy and procedure for adverse event reporting and inform your manager and the infant's pediatrician in order to initiate appropriate interventions.


The CDC recommends informing the mother who expressed the breast milk about the mix-up and determining if she's been tested for HIV. If so, is she willing to share the results with the parents of the child who received the wrong bottle? If not, is she willing to be tested?


The parents of the child who received the wrong bottle should also be informed of the error and the possibility of disease transmission, but reassure them that the risk is very small.


Source: Centers for Disease Control and Prevention. What to do if an infant or child is mistakenly fed another woman's expressed breast milk.



When in doubt, keep advice to yourself

A friend of mine who's not a nurse has a habit of asking for my advice about her family's health issues. The other day, she said, "My husband's doctor says he might have adhesions from his prior surgery. What does that mean?" Can I answer questions like this without getting into legal hot water?-K.L., CALIF.


You could say, "I can tell you what the term usually means, but I can't say what it means in your husband's case." Better yet, encourage her to write down her questions and ask the healthcare provider to explain anything she doesn't understand.


Friends and family members may rely on you for healthcare advice, but be careful: This is an area where you can easily let your guard down and forget to respond cautiously. If someone following your advice is harmed, you could be sued for giving inappropriate advice and not acting as a reasonable and prudent nurse-even though you weren't working as a nurse at the time of the conversation.


Legally, you're not required to answer nursing or medical questions when you're off duty. If you choose to offer advice, do so only within the confines of your nurse practice act, education, and experience. Don't speculate about a person's illness, don't offer a medical diagnosis, and never suggest that someone disregard a healthcare provider's instructions or advice. In short, use common sense and make sure you know and follow standards set by your state's nurse practice act, state law, professional organizations, and your malpractice insurance carrier.


Source: Mackay TR. Legal risks while off duty. In: Ferrell KG, ed. Nurse's Legal Handbook. 6th ed. Philadelphia, PA: WoltersKluwer; 2016.