----- Original Message -----
From: "Denise Fisher" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, August 09, 2008 5:35 AM
Subject: [LACTNET] varicella zoster - chickenpox


**Hello Denise,

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

**Good idea, Denise! I have nothing to offer in that respect, but the lack
of logic is probably why I found it hard to remember the differences between
the one illness and the other, when I was studying. I came to a very general
conclusion: you'd rather not have the baby catch the illness, but because
many illnesses are there before you know it, you'd better breastfeed to
offer immunologic substances and separation and contraindication are rarely
necessary. Some time ago, someone clarified the HIV-issue in that respect:
either no bf (so as to not transmit the virus, even though baby might die
from another or even this same infection through a different route) or
fully, because partly bf still might bring on the virus, but robs the baby
of the antibodies and damages the GI-tract, which makes the baby very
vulnerable. I'm always really fascinated by Mother Nature's wisdom, so I
would also like to hear more on chickenpox.

Warmly,

Marianne Vanderveen, Netherlands

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