PS., As far as I can see,  one issue is the sputum tests, which must be
clear of TB. From Ruth Lawrence's book, p. 573, "In the absence of
tubercular breast infection in the mother, transmission of TB through
breast milk has not been documented. Thus, even though temporary separation
of the infant and mother may occur pending complete evaluation  and
initiation of adequate therapy in the mother and prophylactic isoniazid
therapy (10 mg/kg/day as a single dose) in the infant, breast milk can be
expressed and given to the infant during the short separation .
Breastfeeding can safely continue whether the mother, infant, or both  are
receiving antituberculous therapy. "

There is MUCH more informatin there on this, and I can't type it all ..but
go to this book, the CBI, and your PL.  Separation has to continuie until
three negative smears are obtained.  Others in the household must be
evaluated for positive disease as well.

Perhaps the baby can take fluids in a cup, or on a spoon with solids if
baby takes them. It will be a trying period, but should be workable (with a
lot of angst, I understand). Does this mother have access to a pump? If
not, (and maybe even if so), she should be taught hand expression right away.

I type this with the warning that I am NO expert on TB disease in bf
mothers, and that you should check with more knowledgeable physicians who
have experience in communicable diseases.

Kathleen

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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