Even with careful precautions, a mother's expressed breast milk is sometimes given to another mother's child by mistake — in child care, for example. If it happens, the goal is to keep fear down and handle it properly.
The risk is small
Few illnesses spread through breast milk. Its special properties actually help protect babies from colds and other common childhood viruses. Still, both families must be told about a mix-up — and told that the chance of it passing on an infectious disease is small.
What to do
1. Talk to the mother whose milk was given. Ask her:
- When the milk was expressed
- How it was handled before it reached the caregiver or facility
- Whether she will share her medication use, any recent infectious disease, and whether she had cracked or bleeding nipples while expressing
2. Talk to the parents or guardians of the child who drank it.
- Tell them their child was given another mother's expressed milk.
- Tell them the risk of infection is small.
- If you can, share when the milk was expressed and how it was handled.
- Encourage them to tell their child's doctor, with any details known.
3. Leave medical decisions to the doctor and family. Whether the child needs any care or testing depends on the details, and the infant's physician and parents or guardians should decide together.
Specific concerns
| Concern | What CDC says |
|---|---|
| HIV | Routine U.S. prenatal care tests for STIs and HIV, so most U.S. women with HIV are identified before or during their hospital stay, and most are on antiretroviral therapy (ART). For mothers on ART with a sustained undetectable viral load, the risk of passing HIV through breastfeeding is under 1% — and most U.S. women with HIV don't breastfeed if their viral load is detectable. So the risk from one bottle of another mother's milk is very low, and CDC knows of no evidence of HIV ever spreading to a child this way. |
| Hepatitis B and C | Very unlikely. Hepatitis B and C don't pass from a woman to a child through breastfeeding or close contact unless there's exposure to blood. There's no evidence that breastfeeding spreads hepatitis C, which has no vaccine. |
| Medications | Many drugs pass into breast milk, but most have little or no effect on babies; only a few shouldn't be used while breastfeeding. The risk from a single exposure is very low. |
Most U.S. infants also get the hepatitis B vaccine: a dose shortly after birth, a second at 1–2 months and a third at 6–18 months. A baby who hasn't been vaccinated, or whose schedule was interrupted, should be vaccinated as soon as possible under ACIP's recommendations.
Preventing mix-ups
Child care facilities can:
- Review and update their policies for storing and handling breast milk
- Train or retrain every staff member in safe storage and handling
- Label each container of expressed milk with the child's name
- Use different colored rubber bands on each baby's bottles, or a separate bin for each baby
Learn more
- Contraindications to breastfeeding or feeding expressed milk
- Vaccines, drugs, alcohol and breastfeeding
- Breastfeeding and HIV
- Storage, handling and preparation of breast milk in early care and education programs
Sources
Based on "Breast Milk Mix-Up," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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