Our policy calls for administration of immunoglobulin against varicella to
the infant if mother comes down with it less than 48 hours before, or 5 days
after birth.  It is thought that the baby lacks antibodies if mother's
illness breaks out in this period, and it is feared that there is a high
mortality rate in newborns if they get varicella with no maternal
antibodies.  Pregnant women can also get very very ill with varicella; we
nearly lost a mother to it a number of years ago.

But simply not breastfeeding at the breast will not prevent the infant from
getting infected.  Varicella is one of the most contagious viral illnesses
known, and is spread by droplet from the respiratory tracts of infected
persons.  Face masks provide no real protection either.  The viral load is
highest in the 24 hours BEFORE the pox appear, and declines thereafter
during the course of the illness.  It is not especially contagious by
contact at all, but since it is hard to be in skin contact with mother's
breast without mother breathing on the baby, this situation would provide
plenty of opportunity for contagion.

The baby needs to be protected whether mother is breastfeeding or not.

If the maternal illness appears more than 2 days before or later than 5 days
after birth, the baby will either have gotten some maternal antibodies, or
be able to mount more of an immune response itself.

Cheers
Rachel Myr
Kristiansand, Norway

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