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Date: | Wed, 8 Mar 2006 02:51:06 -0500 |
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Just a case study to consider-
I had a slightly different case about 5 years ago. (I was actually there for a consult because the
baby would not latch- tongue sucker- big time.) Mom showed signs and symptoms of a primary
chicken pox outbreak about 5 hours after the birth of her baby (very quick 3 hour labor for a first
time mom). Normally the doctor would have strongly advised, removal the baby from Mom's care
and had Mom pump and give milk, but they were all unsure of what to do since this Mom had a
positive varicella titer in her chart within the past year. Before she was pregnant, She had asked
for the chicken pox vaccine (she is a teacher) because she had never had the chicken pox. The
doctor ordered a titer and her request was turned down by her HMO after her titer came back with
sufficient antibodies in her blood. When she presented with chicken pox in the hospital so soon
after the birth of her baby, the doctors did not know what to do. I gave the parents the
information I had from Lawrence, Riordan and Auerbach and my Breastfeeding Answer Book. The
thinking at that time? If she has antibodies in her blood to begin with, then they should be in the
milk, and the baby was already exposed in utero (perhaps that is why her little girl made a hasty
exit at 38 weeks). The questions- Was breastfeeding with Mom going to expose her more than
when she was in utero? What was more detrimental- formula and denile of a mother's loving care
or longer exposure to the chicken pox? After many calls to two local children's hospitals and a
conference with Mom, the doctors decided to treat this like a case of chicken pox in the family and
encouraged her to keep nursing. If I remember correctly, they gave Immuno-globulin/and anti
viral meds and left it at that. Baby did get the chicken pox, a very mild case, about two and a half
weeks later. Baby did very well and had no problems...
I don't think this was something the doctors were taking lightly, but they did take into account this
Mom's strong desire to breastfeed and presented her with all of the risks and possible outcomes.
If the baby had contracted chicken pox within the first seven days, there would have been no
telling if she had contracted it from mom in uetero or afterwards. Bottom line was that they really
did not know what would happen, but erred on the protection and superior nutrition of
breastmilk. This practice was not particularly breastfeeding friendly (they had mom pump and
dump for a week for an antibiotic for Bacterial vaginosis (BV) when the baby was about 15 months
old- poor Mom never did get babe back to breast).
Wamly,
Charity M. Pitcher-Cooper BSN, RN, CBE
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