It is so depressing that these questions keep coming up.  It is so
depressing that breastfeeding is always sacrificed without the people
who are supposed to be taking care of the mothers sitting for a second
and thinking.  The knee jerk reponse--stop breastfeeding.  AARGH!
Breastmilk guilty until proved otherwise; formula safe unless proved
otherwise.  Despite all the studies demonstrating the risks of formula
feeding, we hold off breastfeeding until we can prove it is safe.

Urokinase is an enzyme.  It is given by injection because it is, like
most enzymes, destroyed in the gut and not absorbed.  Although I do not
have information about molecular weight, I would guess the molecular
weight high, so that urokinase would not even get into the milk.

Is it a coincidence that this occurs in St. Louis, where a chief of
pediatrics says that the AAP guidelines are too difficult for women?
Probably not, but what is depressing is that each one of us could tell
similar stories wherever we live.

Jack Newman, MD, FRCPC