I recently had a discussion with some of our students about maternal
chickenpox and the recommendations for breastfeeding of the newborn.
It is widely reported that maternal chicken pox acquired between 5 days
before to 2 days after birthing causes very serious illness in the
newborn. This virus is highly contagious.

The major breastfeeding texts (Riordan, Lawrence, Core Curriculum)
recommend that the baby be immediately isolated from his mother
presumably until the last lesion has crusted - expressing breastmilk for
the baby is OK. The references listed for this advice aren't convincing.

This doesn't make sense to me. The mother is infectious from about 2
days before the rash appears - chickenpox won't be diagnosed until the
rash has appeared. Transfer of virus will have occurred
transplacentally. If she doesn't have lesions until 2 days after
birthing she will have been infectious for the last two days anyway, and
unwittingly infected her newborn baby.
In view of the fact that the newborn is at extremely high risk of
developing this life-threatening illness regardless of isolation, I
would think that keeping mother and baby together to enhance
breastfeeding and all the other benefits gained by being in skin-to-skin
with his mother would be the management expected - additional to medical
management.

I'm not alone in this conclusion: in a quick internet search the Swedish
recommendations, Australian recommendations and British recommendations
support this view.
Here's the link to a paper published in the Medial Journal of Australia:
http://www.mja.com.au/public/issues/174_06_190301/heuchan/heuchan.html

Would love to have a professional discussion about this to arrive at
concensus for breastfeeding management.

--
Denise Fisher,
Health e-Learning

You must be the change you wish to see in the world.
Mahatma Gandhi

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