CBS Safety & Infection Control 3 — Questions and Answers
Question 1: A mother asks how long freshly expressed breast milk can safely remain at room temperature (77°F/25°C). What is the correct answer?
- 1 hour
- Up to 4 hours (Correct answer)
- Up to 8 hours
- 12 hours if the room is cool
Correct answer: Up to 4 hours
Freshly expressed breast milk can safely remain at room temperature (up to 77°F) for up to 4 hours under clean conditions.
Question 2: Which of the following maternal medications is a contraindication to breastfeeding due to infant safety concerns?
- Amoxicillin
- Ibuprofen
- Radioactive iodine-131 (Correct answer)
- Metformin
Correct answer: Radioactive iodine-131
Radioactive iodine-131 is excreted in breast milk and is contraindicated during breastfeeding due to the risk of neonatal thyroid damage and radiation exposure.
Question 3: A preterm infant in the NICU is to receive pasteurized donor human milk. Which pasteurization method is the standard for donor milk banks?
- Flash pasteurization at 72°C for 15 seconds
- Holder pasteurization at 62.5°C for 30 minutes (Correct answer)
- Ultra-high temperature (UHT) at 135°C
- Cold pasteurization using UV-C light only
Correct answer: Holder pasteurization at 62.5°C for 30 minutes
Holder pasteurization (62.5°C for 30 minutes) is the current standard used by HMBANA-accredited human milk banks to eliminate pathogens while preserving nutrients.
Question 4: Which cleaning step should a mother perform FIRST when washing manual breast pump parts after each use?
- Sanitize parts in boiling water immediately
- Rinse parts under cold running water before washing
- Disassemble and wash parts with hot soapy water in a dedicated basin (Correct answer)
- Air dry parts on a clean towel without washing
Correct answer: Disassemble and wash parts with hot soapy water in a dedicated basin
CDC guidelines recommend disassembling and washing pump parts with hot soapy water in a dedicated basin as the first cleaning step after each use.
Question 5: An HIV-positive mother in a high-income country asks about breastfeeding. What is the current US recommendation?
- Breastfeeding is safe if the mother maintains an undetectable viral load
- Breastfeeding is recommended with close monitoring of infant HIV status
- Breastfeeding is not recommended due to risk of HIV transmission through milk (Correct answer)
- Breastfeeding is allowed only with antiretroviral prophylaxis for the infant
Correct answer: Breastfeeding is not recommended due to risk of HIV transmission through milk
In the United States and other high-income countries where safe formula feeding is available, HIV-positive mothers are advised not to breastfeed to eliminate the risk of postnatal HIV transmission.
Question 6: What is the recommended approach if a small amount of one mother's expressed milk is accidentally given to another mother's infant in a hospital setting?
- No action is necessary since breast milk is sterile
- Immediately administer HIV prophylaxis to the infant
- Treat as a potential blood/body fluid exposure and follow institutional exposure protocols (Correct answer)
- Discontinue all breastfeeding for 72 hours
Correct answer: Treat as a potential blood/body fluid exposure and follow institutional exposure protocols
Inadvertent exposure to another mother's breast milk should be handled as a potential blood/body fluid exposure per institutional protocols, which include parental notification and infectious disease consultation.
Question 7: A mother with herpes simplex virus (HSV) lesions asks about breastfeeding safety. What is the key determining factor?
- Whether the mother is on antiviral therapy
- The location of the HSV lesions relative to the breast and nipple (Correct answer)
- The gestational age of the infant at birth
- The HSV serotype (type 1 vs. type 2)
Correct answer: The location of the HSV lesions relative to the breast and nipple
Breastfeeding is safe with HSV unless there are active lesions on the breast or nipple; lesions at other body sites do not contraindicate breastfeeding if covered.
CBS Safety & Infection Control 3
A mother asks how long freshly expressed breast milk can safely remain at room temperature (77°F/25°C).
What is the correct answer?