Thank you kindly for the information, Catherine. I ask your permission to
share part of your reply with her.
As I said, the question was mostly for my own curiosity, as when I called
her, the mother said she had stopped breastfeeding 5 weeks ago.
I looked up BtK on Google and of course, found some very, very
complicated information. Some of it seemed to indicate that that
particular form of immune deficiency is x-linked, happening only in males
born to women who are carriers.
Nevertheless there are many other kinds of immune deficiencies, and
ongoing research, especially in the genetic field.
I found one site that had links to
International Patient Organization for Primary Immunodeficiencies (IPOPI)
March of Dimes Birth Defects Foundation
(BTW, I was very impressed with the breastfeeding info on the MOD site,
giving a few "quick tips", benefits to baby and mom, and strongly
advising forming a personal support system prenatally and prominently
highlighting the services of an IBCLC and links to ILCA and LLL. I will
be sure to recommend it to moms with internet capabilities from here on.)
I would really like to reply to her in some way, assuring her there was
nothing harmful in her milk per se, and that it was beneficial to her
baby that she breastfed for the 6 weeks that she did, and the same would
go for any future children she might have. I will refer her to both these
websites.
I think she got the impression that the enzyme was actually in her milk
and harmful to the baby, as she seemed to infer that she had taken the
baby to the doctor for some kind of problem that she assumed was due to
feeding. (It might very well have been relative lactose overload, etc.
etc. or expectations that the baby would always eat and then go to sleep
for the next 2-3 hours, etc. etc. but at the time, I felt it would be
intrusive to ask her.)
I frankly wouldn't want to seem in any way to be urging her to
necessarily relactate for this child. First, because I know it requires a
distinct degree of dedication, and is a time-consuming process and she
has already returned to work. Second, I am wondering whether lactation,
at least long-term, in someone who is immunocompromised, might in some
way be a drain and somewhat of a risk factor for her own health. I do not
remember whether her baby was male or female, and that possibility might
make a difference in the decisions of such mothers, even if there were
some immune bodies lacking in their milk.
That statement of course belies my own background in medically-oriented
nursing.
I am certainly open to changing my opinion on that, but I don't want to
seem to come on as "pressuring the mother" in any way as I have sometimes
heard others do. I did not, at the time, ask her "How did you feel about
that", and I suppose that might be a good place to begin, when I contact
her with the websites.
You made a very good point about there being so many other things in her
milk that are still beneficial for the baby (especiall as compared to
ABM!).
Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
On Wed, 25 Feb 2004 10:21:22 +0800 Catherine Fetherston
<[log in to unmask]> writes:
> On 24/2/04 9:50 PM, "Automatic digest processor"
> <[log in to unmask]> wrote:
>
> > I recently talked to a mom whose physician recommended early
> weaning (5
> > weeks ago) due to "an enzyme in her milk caused by her
> > hypogammaglobulinemia".
>
>
> People with hypogammaglobulinaemia are very vulnerable to infection,
> they
> have very low levels of immunoglobulins and cannot respond
> adequately to
> infectious insults (particularly encapsulated bacteria and viruses)
> This
> results in recurrent and severe occurrences of infections such as
> pneumonia, sinusitis, osteomyeltitis, dermatitis and septicaemia.
>
> Bruton's tyrosine kinase (Btk) is required for human and mouse B
> cell
> development. Btk deficiency causes X-linked agammaglobulinaemia
> (XLA) in
> humans and X-linked immunodeficiency in mice. I'm assuming this is
> the
> enzyme to which the doctor refers.
>
> I cannot see why this would lead to advice to wean. Certainly her
> breastmilk
> will be immunoglobulin deficient (and it would be interesting to see
> a
> profile of her breastmilk immune components). However there are many
> other
> antimicrobial components in breastmilk so it is still important for
> the
> infant protection wise. I cant imagine why breastfeeding would be
> deleterious to the mother with this condition- I would be interested
> to hear
> his explanation.
>
> Cathy Fetherston
> Western Australia
>
>
>
>
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