Here is some information to consider for the infant with Linear IgA  
Bullous Dermatosis

Infants do not make a lot of their own antibodies. It takes several  
years before they are making the level of antibodies in adults.  
Because they make very little of their own antibodies they receive  
antibodies passively from the mother for protection from infection.  
There are two mechanisms for transferring antibody to the infant. The  
first way is the transfer of the IgG type of antibody across the  
placenta during gestation. The second way is the transfer of  
antibodies (primarily the IgA type) during breastfeeding.

It is possible to transfer autoimmune antibodies from the mother to  
an infant. This is what happens during neonatal lupus. Autoimmune IgG  
antibodies cross the placenta during gestation and the baby then  
shows signs of autoimmune disease. These symptoms will go away around  
six months of age because by then the maternal IgG antibodies will be  
completely degraded.

Since Linear IgA Bullous Dermatosis is due to the IgA type & this is  
the main type of antibody in breastmilk it is conceivable that  
breastmilk is the source of the antibodies. However, I would want to  
have some additional information. They need to know the source of the  
autoantibodies - is it the mother or the baby?

Has the mother been tested for autoantibodies? Does she have signs of  
autoimmunity? It is possible for her to be undiagnosed and be making  
the autoantibodies. If she is the source, then cessation of  
breastfeeding (hopefully by switching to donor human milk) will  
resolve the problem.

On the other hand, if the baby is the source of the autoimmune IgA  
antibodies then breastfeeding can continue without any problem.  
However, the baby should probably be treated with a course of  
predisone to calm down the immune system.

I hope this is helpful.
Warm regards,

Laurie Shornick, PhD

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