Brady, 
Basic science suggests that this baby has been and/or will be exposed to both pathogen and antibodies to pathogen as well as the antibiotics used during pregnancy, and is likely to go on being exposed, so that breastfeeding and breastmilk is even more important to this child than to a child not similarly at risk. How will formula feeding, with its innate distortion of the developing infant immune system and its development, its possible endogenous pathogens, its certain distortion even of the normal microbiome, and its added stresses on the neonate, help protect this child? Breastmilk will go on providing specific antibodies to MRSA as well as to any other bug the mother has encountered. Why would anyone be daft enough to suggest such a mother should not breastfeed? 

> She says her OB has told her she can't breastfeed, not because of the
> medicine, but because they're worried about her passing MRSA to baby during
> birth.
This is muddled, surely. Who breastfeeds during birth!!!  As you say rightly, In my mind, "that logic doesn't fly, because even if she were to pass this on to her baby during birth, wouldn't she be better off nursing to prevent infection or curb outbreak?" Of course she would. She might even try breastmilk lavages of any developing sores, in my opinion.
> 
> Would it be appropriate to recommend, maybe for doc's sake, that mom's milk
> and baby be tested to check for MRSA? What happens if:
> 
> -milk alone tests positive - safe to nurse or not, with or w/o meds?
> -baby tests positive - safe b/c mom has same thing, will help prevent probs?

Remember that breastmilk will test positive via PCR to any pathogen the mother is exposed to, as fragments (often not viable) are there to immunise the baby. One study showed 700species of bacteria in healthy breastmilk, not to mention viruses. It's not whether a bug is there, it's in what form, and what else is there as well, that determines infectivity. Breastmilk never was sterile and hopefully never will be. The PCR traces of HIV that led to early kneejerk warnings against breastfeeding led to many needless deaths of children who might well have survived as immunised  offspring had they been exclusively breastfed: it's interesting to watch how WHO advice has evolved since the 1980s. 

In my view, there is never a totally safe option which excludes all risk,  but the safest possible by a long country mile is breastfeeding. And yes, take care about preventing nipple trauma, but that should be avoided for every mother. So support this mother to exercise her right to breastfeed and help protect her baby's right to be breastfed.

Hope this helps. What do others think? Maureen

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