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Subject:
From:
Brandy Hansen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 30 Apr 2013 10:46:10 -0500
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PTP

Saw a 31wk preg mom in class yesterday.  States she has been battling MRSA
for 5 years now.  The only place she has wounds are in the groin and armpit
areas where she sweats and has had folliculitis in the past.  She said they
have tried rounds of other antibiotics over the years to no avail at
eliminating--wan't able to recall all, but has included previous
Doxycycline and Keflex, currently on Bactrim (sulfamethoxazole +
trimethoprim variety) taking one pill 800mg per day for
management/prevention of sores, and is to take 2 pills a day when sores
break out.

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.

My question is is this really an accurate assessment of risk or proper
method of preventing baby from acquiring it, by telling mom she shouldn't
nurse?  The way she's putting it, it sounds like the doc thinks baby may
acquire it during the birth process b/c of proximity of eruptions to the
birth canal/pubic area, and that somehow breastfeeding might play a part.
 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?  My thought is that since outbreaks are nowhere
near the breast (though, with the potential for nipple damage, a wound
could conceivable come up there after birth) we would have to be careful
about management of breastfeeding to prevent or manage early problems ASAP.


I searched in the LACTNET archives and the last mention seems to be in
2005; is there any updated info seven years later?  Seems like CDC saying
it's find to BF and breastfeed as long as wounds that might touch the baby
are covered, but ABM protocol from 2010 deals specifically with MRSA in
relation to mastitis, and this isn't my client's case.

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?

Sorry so many questions... mom really wants to nurse, and she is pretty
upset at doc's suggestion. I want to help her advocate for herself, and
I've given her meds info and told her about CDC recommendations to nurse
and BF if there's no outbreaks on breast that are uncovered, which she is
relieved by, but I told her I would dig for better info as well.

Thanks in advance for any help.

-Brandy J. Hansen
The Mobile LC
309-319-6619
[log in to unmask]
Supporting moms via home/hospital visits, phone, Skype, text, email, chat

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