Hi Natalie

From Ruth Lawrence's paper:
http://www.mchlibrary.info/pubs/PDFs/breastfeedingtib.pdf
Herpes varicella-zoster virus (which causes chicken pox) is one of the most
contagious of diseases.85 The incidence is reported at 5/10,000 pregnancies.
As the vaccine becomes more widely used and natural disease less likely, new
guidelines may be necessary.
Presently, risk of infection to the neonate depends upon when the disease
occurs during the mother’s pregnancy or postpartum period. Congenital
chicken pox, by definition, occurs in neonates younger than 10 days of
age and is associated with significant mortality. Varicella virus DNA has
been detected in breastmilk, but the spread of disease from mother to infant
after delivery is by direct contact, not by feeding. Infants born to mothers
who have varicella can develop the infection between 1 and 16 days of life.
The usual time interval from onset of rash in the mother
to onset in the neonate is 9 to 15 days. When maternal chicken pox occurs
immediately postpartum or within six days of
delivery and no lesions are present in the neonate, mother and infant should
be isolated from each other. Only half of the neonates will develop the
disease, but all of them should receive varicella zoster immune globulin
ZIG) immediately at birth. When the mother becomes noninfectious, she can be
with her
infant and breastfeed.

and from:
http://www.phila.gov/health/units/decywh/Special_Prog/Breastfeeding/apinkJune20021.PDF



chickenpox “When maternal chickenpox occurs within 6 days of delivery or
immedia tely postpartum and
no lesions are present in the neonate, mother and infant should be isolated
separately. Only half the
infants born to mothers who developed the disease 7 to 15 days before
delivery will develop the disease.
They should receive zoster immune globulin (ZIG) ... If no lesions develop
by the time the mother is
noninfectious, the infant and the mother may be sent home together. When the
mother and infant can be
together, the child can be breastfed.”2
2 RA Lawrence, RM Lawrence: Breastfeeding: A Guide for the Medical
Profession (5th Edition).
Philadelphia: Mosby, 1999, pp. 584-588
RA Lawrence: A Review of the Medical Benefits and Contraindications to
Breastfeeding in the United
States, 1997, pp. 17-19


I believe that antivirals must be given within 72 hours of exposure. Is this
right?
I believe the concern is in the newborn, not the older baby. I don't think
withholding BF will achieve anything

hope this helps
Karen Clements
Melb Aust

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