The woman who is a MRSA carrier should be treated as any normal 
breastfeeding mother. Many people carry MRSA and don't even know it. In 
fact 35-50% or more of people carry staph aureus in the nose, and now 
that MRSA is so prevalent, most of that staph is now methacillin resistant.
The OB probably is screening her because hospitals have strict rules 
about known MRSA carriers. They have to be isolated when they are in the 
hospital.
Her baby will be exposed to MRSA because she is a  carrier, but really 
who cares, since anyone who holds her or cares for her, such as 
relatives or the hospital nurses, could also be carrying MRSA.
If she develops a breast mastitis or nipple infection the doctor must do 
a culture and r/o MRSA, so that she is treated with the right 
antibiotic. In fact, if she develops a breast infection, the first 
antibiotic to consider is TMP sulfa or other antibiotics appropriate for 
MRSA. Sensitivities are important to do, since MRSA might or might not 
be sensitive to clindamycin, which is useful for a severe mastitis.
If she develops nipple sores, I would have her use mupirocin ointment 
prophyllactically to prevent a deeper breast infection.
She does not need to stop nursing if she develops a MRSA mastitis, it 
should be treated like any other mastitis, but it is important to know 
that MRSA mastitis patients are more prone to abscesses.
She will not asymptomatically infect her baby with MRSA.

I hope this helps.
Anne

Anne Eglash MD
Clinical Associate Professor
Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)

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