<<Dr Jack said, "If Lawrence says that giardia can be transmitted through
breastmilk, I am amazed.  I haven't had a chance to check, but I think this is
*extremely* unlikely.  This is a protozoa, it is huge.  How would it
get from the mother's gut, to the milk?  How would it get into the
milk?">>

In Lawrence's book, she states, "Giardia have also been reported to appear
in mother's milk, and the parasite has been transmitted to newborns via
that route.  The interrelationships of the parasite and the bf host
continue to be studied".

However (me talking now)--I recently got my hands on a copy of a report
that Ruth Lawrence prepared for the Maternal & Child Health care divison of
the HRSA--" A Review of the Medical Benefits and Contraindications to
Breastfeeding in the United States".  The report was in response to
requests from the US General Accounting Office that USDA and DHHS have
written policies defining the contraindications of bf.  Dr. Lawrence did
the report, but also stated that she could not prepare this type of report
without including the benefits of bf.  YEA!  According to this new report
(printed Oct. 1997), the only infectious diseases that are
contraindications in the US are HIV, and HTLV-1.  She does not specifically
list Giardia but she does talk about Toxoplasmosis which I would "guess"
would be fairly similar since it is also a protozoan organism. "Toxoplasma
gondii have been isolated from breastmilk, menstrual fluid, placenta,
lochia, amniotic fluid, embryo, and fetal brain in 33% of the subjects in
one series.  Transmission during bf in humans has not been demonstrated.
It is possible that unpasteurized cow milk could be a vehicle of
transmission.  THE HUMAN MOTHER, HOWEVER WOULD PROVIDE APPROPRIATE
ANTIBODIES VIA HER MILK."  I have read several references to the effect
that breastmilk actually kills the protozoa.

I would also think that it would be very difficult to "prove" that Giardia
infections were transmitted via breastmilk unless the child was exclusively
bf.  Is it possible Dr. Jack (or anyone with more medical background than
me--I have none), that if the mother or another family member was infected
that the protozoa could be transmitted by fecal/oral route??   Anyway, it
just seems to me that if the baby/mother were infected--you would just RX
nursing couple.  Another thought--if you were to discontinue bf for the
infected mom--wouldn't the baby be more likely to be exposed to the source
of infection (such as water or cow's milk)?
                            Pam Holland, BS, IBCLC
                            WIC BF Coord., Savannah, GA