"Nancy, are you saying that any Mom who is CMV positive should not breast
feed her premie?  She should instead pump and freeze?"

If the baby is <32 weeks, yes, that is what most neonatologists and 
infectious disease experts recommend.  In practice the 23-28 week infants 
rarely feed on day 1 or 2 so the milk is frozen.  I also try to use the first 
2 weeks of milk in order pumped, so most of the milk for the tiny ones ends 
up frozen. Between 28-32 weeks is a grey zone.  > 32 weeks, there have been 
no reported cases of illness due to CMV. In practice, any baby who is capable 
of feeding directly at breast may do so. 

We have not established how much of a problem CMV illness in premies is 
nationwide.  I have seen one case (27 weeker) in the last 3 years, but my 
colleagues across town at the University hospital had 2 cases in one year 
with severe illness (both < 28 weeks).  At present there is no "right" 
answer.  We need to balance the considerable benefits of breastmilk and 
breastfeeding with the risk of CMV (which I believe to be low). 
Nancy

Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA
Office: 858-541-4180
Fax: 858-541-4135
Pager: 858-493-0198
Email: [log in to unmask]

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