Gotta love the 'Net. I turned to <www.medterms.com> to find out what
vitiglio is ... it so happens that the "feature story" includes a
description of this very condition. I have reproduced it below (somewhat
shortened) because I found it so informative:
"Vitiligo: Pronounced vit-uh-LIE- go. A condition in which the skin turns
white due to the loss of melanocytes. These cells produce melanin, the
pigment that gives the skin its characteristic color. (Melanocytes also
impart color to the retina of the eye and the mucous membrane tissues lining
the inside of the mouth, nose, genital and rectal areas). In vitiligo, the
melanocytes are mysteriously destroyed, leaving depigmented patches of skin
on different parts of the body. The hair that grows in areas affected by
vitiligo may also turn white.
"Vitiligo is a common disorder. It occurs in 1-2% of people and affects both
sexes and all races equally. Vitiligo is never present at birth. It crops up
between the ages of 10 and 30 in about half of cases and before age 40 in
95% of cases. More than 30% of people with vitiligo have a family history of
the disorder, pointing to the presence of genetic factors capable of
contributing to the condition.
"As the skin gradually loses it's color, patch by patch, other people may
treat someone with vitiligo like a leper, thinking they have a contagious
skin disease ....
"In people with vitiligo, the melanocytes self-destruct, probably because of
an autoimmune reaction in which the body mistakenly attacks its own cells.
The resulting white patches of skin may enlarge and increase in number for a
while, and then the condition may stabilize, only to start up again later.
"Injury, illness, a bad sunburn and severe stress have been known to provoke
the onset or progression of vitiligo. Vitiligo is sometimes associated with
more serious disorders that also have an autoimmune cause, including:
hyperthyroidism (overactivity of the thyroid gland), adrenocortical
insufficiency (the adrenal gland does not produce enough cortisol), alopecia
areata (patches of baldness), and pernicious anemia (a low level of red
blood cells caused by the failure of the body to absorb vitamin B12).
Vitiligo is also a feature of a number of genetic diseases."
Now -- as for the 29-week-pregnant mom with vitiglio and hypthyroidism: I
assume she is already under treatment for her hypothyroidism and vitiglio.
Ruth Lawrence's 5th edition (at p. 521) states: "If hypothyroidism is
diagnosed, it should be treated with full replacement therapy .... The
medication should be continued after delivery. The mother should be
permitted to breastfeed without question. Data from Bode et al. indicate
there is measurable thyroid hormone in the milk of normal women.
Breastfeeding is not contraindicated." Riordan and Auerbach's 1st ed'n (at
p. 355) suggests that "women whose replacement therapy was determined before
pregnancy should be reevaluated after the baby's birth to determine if
adjustment is necessary."
I conclude that Mom's breastmilk will NOT "cause" her baby to have either
vitiglio or hypothyroidism. If the baby is genetically pre-disposed to
either condition, it's a "done deal." I would encourage her to breastfed
that baby, but to keep in close contact with her own doctors to ensure that
her treatment plan is on target. Moms with *un*treated hypothyroidism may
have a low milk supply ... common sense suggests that Mom pay close
attention to her supply/baby's weight gain to ensure that her treatment plan
is working well.
Liz Brooks, JD, IBCLC
Wyndmoor, PA, USA
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