Mirine wrote about a mother with ciguatera whose baby "experienced several
days of fussiness/fatigue but not enough for the mother to be concerned"
and who "experienced the mild side effect of the toxin with fussiness
according to the mother."

Given the described mildness of the infant's symptoms, I hope that the
mother's paper and the ciguatera research center with whom she is working
will consider the very real possibility that the baby's fussiness and
fatigue could have been infant grief and depression due to the experience
of an abrupt cessation of breastfeeding during the temporary pumping and
dumping as well as the abrupt loss of full mothering (Mirine's post said
the mother was incapacitated in the hospital--I presume the infant
experienced some degree of separation from his/her mother). In other words
(and based only on the information available in Mirine's post and from the
USFDA website [see below]), several days of mild infant fussiness and
fatigue, in and of themselves, in an infant who has abruptly (even if
temporarily) lost breastfeeding and his/her mother do not seem to me to be
sufficient evidence of actual toxin exposure in the infant even though the
mother was diagnosed and treated for Ciguatera.

From the USFDA website: http://vm.cfsan.fda.gov/~mow/chap36.html

"Clinical testing procedures are not presently available for the diagnosis
of ciguatera in humans. Diagnosis is based entirely on symptomology and
recent dietary history."

"Initial signs of poisoning occur within six hours after consumption of
toxic fish and include perioral numbness and tingling (paresthesia), which
may spread to the extremities, nausea, vomiting, and diarrhea. Neurological
signs include intensified paresthesia, arthralgia, myalgia, headache,
temperature sensory reversal and acute sensitivity to temperature extremes,
vertigo, and muscular weakness to the point of prostration. Cardiovascular
signs include arrhythmia, bradycardia or tachycardia, and reduced blood
pressure. Ciguatera poisoning is usually self-limiting, and signs of
poisoning often subside within several days from onset. However, in severe
cases the neurological symptoms are known to persist from weeks to months.
In a few isolated cases neurological symptoms have persisted for several
years, and in other cases recovered patients have experienced recurrence of
neurological symptoms months to years after recovery. Such relapses are
most often associated with changes in dietary habits or with consumption of
alcohol. There is a low incidence of death resulting from respiratory and
cardiovascular failure."


Sincerely,

Cynthia

Cynthia Good Mojab, MS, IBCLC, RLC
Ammawell
Email: [log in to unmask]
Web site: http://home.attbi.com/~ammawell

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