Carol writes:
I actually spoke with Ruth Lawrence about this a couple of years ago and
she advised that the baby who was nursing from a mother with MRSA has
already been exposed to it and is receiving antibodies to it from the mother and
there is no reason to stop nursing and certainly no reason to pump and
dump. The breastmilk should have protective benefits. Is the breast not an
immunological organ?
~~~
Hello All,
I wish this was information that the average MD would be educated about.
Again, I feel like I've heard the death knell for breastfeeding sound in
recent work with a family. Baby healthy and over a month old. Mom nursing one
side, pumping the other due to a painful area we reasoned was either an
inflamed Montgomery gland, an irritated accessory nipple pore or something
else. Signs were not clear for mastitis or abscess, but something was going
on. Mom developed more pain and local swelling, was out of town, dragged
herself back in to see her OB, got a possibly appropriate medication but at
too low a dose ( no culture done) . I referred mom to local Breastfeeding
Medicine doctor, who was too busy to see her. Referred to another
Breastfeeding Medicine MD, who referred her to someone else ( not a
Breastfeeding-specialist person, who then called an Infectious Disease specialist). Next
doctor says "that infection will laugh at the medicine your OB gave you", puts
her on Bactrim ( no culture done) and tells her to pump and dump. Her baby's
burgeoning feeding skills ( his cranial sutures not well aligned, huge
scabbed area on one side from asymmetric use of vacuum, can only latch well
one side, laryngomalacia, and fatigues after less than an ounce of milk
transferred) have really been a lot for her to deal with, pumping, pain, lack of
sleep ( took MDs 3 weeks - significant weight loss and no gain over 2
weeks of life, then referred for frenulum release, even though it was anterior
and visible and commented on in all visits- to get baby's weight to move up
at all). The OB had told her the opposite of what I had suggested in terms
of pumping strategy to deal with that weird area...) and when I shared
with her the information on the medication she'd been given from both Hale and
LactMed, husband said "we decided to play it safe and just give up". This
is how our culture, even our medical professionals view formula
feeding/breastfeeding abandonment/weaning, as "playing it safe" or "erring on the side
of caution." I saw this baby attempt to feed, and I really thought he just
needed a little recovery/healing time and help to move along until he could
feed nicely from both sides and he and his mom would have a nice
breastfeeding relationship. But, mom had been struggling along for weeks
(underproducing with a pump not designed for this work but so popular it is like
blasphemy to even say that where I live...) before I ever met them, and now with
this set of recent recommendations, she's just so overwhelmed, she can't
even imagine breastfeeding or even pumping. It took 4 phone calls,
repeatedly telling her and then also her husband that even if she plans never to
nurse again, she just can't stop pumping right now during a breast infection.
There are so many places where this journey got derailed, then started to
get on track only to be derailed again. I told her my role was to support
her intentions, to make sure she had the best information available, and to
help her with whatever she decides to do, but it's just heartbreaking
watching the effects of the labor, delivery, post-partum experience of this dyad
take their toll on what could have been. It's like the "you have to pump
and dump" was the tipping point for her, and now she can't imagine continuing
in any form. Sigh...
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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