In a message dated 12/2/99 6:47:26 PM Central Standard Time,
[log in to unmask] writes:

<< A friend of mine who is nursing a 2-week-old has just been diagnosed with
 chickenpox.  There are lesions on her areola.  One of her doctors has told
 her it is OK to continue breastfeeding.  The other has told her it is not OK
 because of the lesions. >>

Unfortunately, the baby was exposed to the virus before the lesions appeared.
 Chicken pox has a 7 to 14 day prodrome with cold-like symptoms and the
disease is spread through respiratory droplets.  Since Mom contracted the
disease, she had no prior immunity and did not pass any on to the baby
prenatally or via breastmilk.

It is unfortunate that this mom was not screened prenatally for chicken pox
immunity as she probably was for rubella.  Chicken pox in infants is a very
bad thing.

As for using a shield to prevent contact with the lesions, it's really almost
a moot point.  The baby has already been exposed and will become ill from the
disease.  Further contact with the lesions, crusted or not, will not make
much of a difference.  The baby's pediatrician needs to look into getting the
baby some varicella immune globulin (VZIG) as soon as possible.  This will
provide the baby with some passive immunity to chicken pox.

That said, using a shield to protect mom's nipples from further trauma MIGHT
help.  But then again, the friction of the plastic might not feel to great
either.  However, the open lesions would also be susceptible to bacteria in
the baby's mouth that in normal situations would not go invasive but with a
portal could end up causing a secondary infection.

Best of luck to this mom and baby,
Warmly,
Theresa Chmiel, CLC, ICCE
Las Vegas, NV

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