CMV antibodies passed from Mom to Baby are primarily IgG antibodies, IgM is
much too large a molecule to pass.  We use Igm antibodies as a marker for in
utero INFANT infection when we are trying to decide between passive immunity
(from mom) vs active immunity (from baby).  CMV passage to a full term,
normal infant is not a problem.  The infants get infected, but maternal
antibody protects them against neurologic and other sequellae.  ELBW premies
(< approx 28 weeks) have been reported, presumably because of their very
immature immune system, to have serious sequellae (hepatitis, pneumonitis and
cerebritis) EVEN if mom's protective antibodies are already in the infant.

As promised (a long time ago) I got together a bunch of Infectious Disease
Docs (2 experts/researchers in CMV) and breastfeeding supportive
Neonatologists and we came up with a protocol to help reduce transmission of
CMV in our tiniest babes.
Nancy Wight MD, FAAP, IBCLC
Neonatologist
San Diego, CA

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