This response is for Patricia Predmore, in regards to the breastfeeding
mother with shigella:

Shigella is a bacteria which commonly causes gastroenteritis.  It, along with
Salmonella and Camphylobacter cause much of the "food poisoning" we see.  It
can be transmitted by the oro-fecal route.  That means stool from the mother
must come in contact with the baby's mouth.  This most coomonly occurs from
poor handwashing technique by the mother after going to the bathroom. As far
as I know IT IS NOT TRANSMITTED BY BREAST FEEDING.  This bacteria is
generally limited to the intestine.  Unless the mother is very ill, with high
fevers (more than 102 F) and shaking chills it is very unlikely that there is
any shigella in her blood stream.  If it's not in the blood stream, it can't
get into the breast milk.  Treatment of choice is ciprofloxin or one of the
other floxins.  However, this is not safe for the breast feeding infant.
 Therefore, if the mom is too sick to wait for results of a stool culture
antibiotic sensitivity screen, I'd recommend trimethoprim-sulfa (SEPTRA,
BACTRIM) which can be safely used in the breast feeding mother although some
shigella are resistant to it.

Peter Salomon, MD FACG
Board Certified Gastroenterologist