I need your collective wisdom on this one. I'm asking with the mother's permission. Mom has two sets of twins: identical girls, 4 years old. (Nursed them for about 1 year). fraternal boy-girl twins, 7 months old. (Still nursing). Mother had returned to work as a post office letter carrier, rural district. Worked through the problems of one baby who wouldn't take a bottle, need for her to work extra hours over the Christmas rush, child care, flexible schedule, etc. Last week one of the 4 year olds was diagnosed with acute lymphocytic leukemia. Mom spent a lot of time with her in the hospital, separated from babies. Used her P-n-S, but with the separation, stress, and irregular pumping, she went from getting 8 ounces per breast each pumping time to less than 3 ounces. Frozen milk supply at home was about gone. We talked about ways to build up her milk supply with frequent pumping and snuggling in with all 4 kids at home again. (Child was discharged from hospital on Thursday, April 23.) Milk supply is rebounding now. Babies have gotten used to bottles. They eat solid foods as well. Now are nursing maybe 4 times a day. I encouraged this mom to keep them interested as much as possible. If they stop nursing, there is more risk of them getting sick and then exposing their older sister to infections at home. Nursing times can also help calm everyone down amidst all this stress. Mom is especially concerned over her daughter's low immune status at this time. Child is on prednisone and several other meds. (Mom is looking up names for me.) The question for all of you is, would it be of any help to give breast milk to this 4 year old? Mother thought it would be something she could do to help. There are some viruses that can pass through the milk, but she would probably be exposed to them in other ways if they were present in the home environment. And antibodies in the milk should protect against lots of other pathogens for a child with a weakened immune system. I think that if a baby or nursing toddler/preschooler was diagnosed with leukemia, they would continue to nurse. So I could not think of any reason that giving the mother's breastmilk would be of any harm, and might be of help for this 4 year old at this time. I suggested the mother ask the physicians about this. She says they know she is nursing twin babies and wonders why they didn't suggest this idea. What do you all think about it? Mom also wonders how she would get her daughter to take the milk. She believes she would refuse to drink it. Appetite has decreased dramatically, although she seems to want to eat spicy foods like brats (Wisconsin sausages) and pickles. Would fresh milk be best? (Maybe use it to make instant puddings or milk shakes?) What effect would heating or freezing have on the ability to protect this child from infection? Mother is worried that the identical twin sister will be at increased risk of getting leukemia as well. I don't know about that. The ill child is allergic to peanuts and her twin is not. I always wonder about how accurately twins are identified as identical or fraternal, unless tissue typing is done. Some fraternals can look very similar. And not all identical twins get the same illnesses. Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI [log in to unmask]