<<Dr Jack said, "If Lawrence says that giardia can be transmitted through breastmilk, I am amazed. I haven't had a chance to check, but I think this is *extremely* unlikely. This is a protozoa, it is huge. How would it get from the mother's gut, to the milk? How would it get into the milk?">> In Lawrence's book, she states, "Giardia have also been reported to appear in mother's milk, and the parasite has been transmitted to newborns via that route. The interrelationships of the parasite and the bf host continue to be studied". However (me talking now)--I recently got my hands on a copy of a report that Ruth Lawrence prepared for the Maternal & Child Health care divison of the HRSA--" A Review of the Medical Benefits and Contraindications to Breastfeeding in the United States". The report was in response to requests from the US General Accounting Office that USDA and DHHS have written policies defining the contraindications of bf. Dr. Lawrence did the report, but also stated that she could not prepare this type of report without including the benefits of bf. YEA! According to this new report (printed Oct. 1997), the only infectious diseases that are contraindications in the US are HIV, and HTLV-1. She does not specifically list Giardia but she does talk about Toxoplasmosis which I would "guess" would be fairly similar since it is also a protozoan organism. "Toxoplasma gondii have been isolated from breastmilk, menstrual fluid, placenta, lochia, amniotic fluid, embryo, and fetal brain in 33% of the subjects in one series. Transmission during bf in humans has not been demonstrated. It is possible that unpasteurized cow milk could be a vehicle of transmission. THE HUMAN MOTHER, HOWEVER WOULD PROVIDE APPROPRIATE ANTIBODIES VIA HER MILK." I have read several references to the effect that breastmilk actually kills the protozoa. I would also think that it would be very difficult to "prove" that Giardia infections were transmitted via breastmilk unless the child was exclusively bf. Is it possible Dr. Jack (or anyone with more medical background than me--I have none), that if the mother or another family member was infected that the protozoa could be transmitted by fecal/oral route?? Anyway, it just seems to me that if the baby/mother were infected--you would just RX nursing couple. Another thought--if you were to discontinue bf for the infected mom--wouldn't the baby be more likely to be exposed to the source of infection (such as water or cow's milk)? Pam Holland, BS, IBCLC WIC BF Coord., Savannah, GA