Dear Arly,

I had an email discussion on this topic with Dr. Nancy Powers when I took
the N720 class at Wichita state University last semester. Nancy wrote me
that..."older infants and toddlers can acquire oral herpes simplex as a
primary infection...It does not cause the same severity as in a newborn." In
her opinion "if a mom of an older baby has herpes on her breast, the baby
(or her intimate partner) probably GAVE it to her."

I think Dr. Powers would concur with your idea about immunologic factors
because she says in her lecture, that because older infants and toddlers are
susceptible they can continue to BF. In her experience she says that FF
babies seem to have more severe outbreaks. Maybe you have a way to contact
her in Wichita, Kansas to verify this.

You ask if milk from either breast is equally safe. In *Breastfeeding and
Human Lactation*, (Riordan, 2005), Table 6-1, says that if a breast lesion
is present the care provider should "Discourage breastfeeding from the
affected breast; encourage use of breast pump to maintain comfort and milk
supply; after each use sterilize pump part that comes in contact with the
breast... This is to prevent the infant from direct contact with the
lesion." You can find this here on page 174:
*http://tinyurl.com/bx329j*<http://tinyurl.com/bx329j>
This seems to indicate that the milk (along with the pump part) would
contain the virus and only on the affected side.

Ruth
**
<<I am going to be conservative and assume herpes, as husband has current
outbreak. My edition of Lawrence (5th ed, 1999) says milk is safe but to
avoid contact w/nipple.
Is milk from either breast equally safe?
Is there any published, good, current research to give me a definite on
whether she should pump and dump the affected breast?
Tell me anything you know *for certain* as dumping would change this
baby to a combo ff/bf baby, which would impact his immunological
response to this challenge.
He is four months old, otherwise normal, healthy.
Arly Helm, MS, IBCLC, snowy Sierra Nevadas>>

-- 
Ruth Vishniavsky, RDH, MS, CLC

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