What medical protocols exist for decontaminating infants and breastfeeding mothers after tear‑gas exposure?

1. Immediate steps for exposed mothers: strip and wash to remove surface contamination

The core, repeatedly stated medical protocol is immediate self‑decontamination: remove contaminated clothing and wash the entire body (skin and hair) thoroughly with soap and water before any direct infant contact, breastfeeding, or milk expression, because most irritant effects are from particles on skin, clothing, and in the air and tend to abate after leaving the area and cleaning off (CDC guidance) ^{[1] [3] [2]}. Eye and skin irrigation with copious water is standard first aid for lacrimators and related irritants; randomized trials used water irrigation as the control decontamination method and found it effective enough that participants often left decontamination areas within minutes (baby‑shampoo trial) ^[4]. Practical adjuncts such as brushing off and ventilating hair or standing in a fan can disperse particles, but thorough soap‑and‑water washing remains the authoritative recommendation (decontamination guidance) ^[5].

2. Decontaminating infants and immediate infant care

For infants exposed to tear gas, guidance emphasizes gentle decontamination and symptom‑driven care: irrigate eyes and wash exposed skin with cool or lukewarm water and mild soap if there is burning or visible residue, and avoid aggressive scrubbing that could worsen irritation (community pediatric guidance and advocacy groups) ^[6]. Infants can be more vulnerable to respiratory injury from prolonged or high‑dose exposures—case reports include an infant developing pneumonitis after indoor exposure to CS—so any respiratory distress, persistent coughing, wheeze, vomiting, or changes in alertness warrants urgent medical evaluation (AEGL/NRC review and case reports) ^[7]. Systematic reviews and pediatric analyses note limited data on infants and call for lower thresholds to seek care in this population (PubMed review) ^[8].

3. Pumping, milk handling, and short‑term feeding decisions

Current CDC guidance states that it is not known whether riot‑control agents appear in breast milk and that pumping and discarding milk is generally not thought to be necessary after exposure; instead, mothers should decontaminate before breastfeeding or expressing and discuss resumption with a clinician if medically concerned (CDC breastfeeding pages) ^{[1] [2]}. The clinician‑facing CDC guidance adds that the benefits of breastfeeding often outweigh theoretical exposure risks and that decisions to pause or resume breastfeeding should consider the availability of safe alternate nutrition and the clinical status of mother and child ^[2]. This is an evidence‑sparse area where public health advice errs on minimizing skin/air exposure rather than routinely recommending milk disposal ^{[1] [2]}.

4. When to seek medical care and clinician involvement

Medical assessment is recommended whenever there are severe or persistent symptoms—significant eye pain or visual change, ongoing respiratory distress, vomiting, or systemic illness—or if the exposure was prolonged, occurred in an enclosed space, or involved infants and people with preexisting respiratory disease; clinicians should guide decisions about temporarily holding feeds versus continuing breastfeeding because the balance of risks and benefits depends on clinical circumstance (CDC clinician guidance; AEGL summary) ^{[2] [7]}. Public‑health toolkits for other contaminants (e.g., radiation) and chemical emergencies similarly advise self‑decontamination followed by clinician consultation when in doubt, and to weigh the absence of strong evidence for milk transfer against breastfeeding benefits (CDC radiation/chemical emergency guidance) ^{[9] [2]}.

5. Limits of evidence and key uncertainties

Multiple official sources acknowledge significant evidence gaps: there are virtually no direct studies measuring tear‑gas agents in human breast milk, few pediatric case series, and most controlled exposure data come from adult volunteers or animal work, leaving vulnerable groups underrepresented; authoritative agencies therefore recommend decontamination plus individualized clinical decision‑making rather than blanket prohibitions or mandates to discard milk (CDC pages; HKMJ review; NRC/AEGL) ^{[2] [10] [11]}. Practical cleanup of contaminated environments and belongings is discussed in remediation literature, but household‑level guidance varies and professional hazmat remediation is sometimes advised for indoor persistent contamination (trauma services) ^[12].