I'm in the process of doing some literature review and writing about
immunizations.  I think the most important thing is true informed
consent.  I encourage full immunization but try to give parents full
information including both the public health and individual health
aspects of the vaccines.  I also encourage parents not to lump all
vaccines as "good" or "bad" but to look at each disease and each vaccine
individually.  For example, I have one mom who has chosen to delay most
vaccinations but has given her baby Hemophilus vaccine since that
particular disease is a risk for her child right now.  She plans to wait
until she is old enough for the acellular pertussis vaccine (18 months),
and we are still negotiating about the other ones.  This is a child who
is fully breastfed and cared for at home, so I don't feel that the timing
of vaccines is as urgent as for a child in day care, although as I said,
I encourage mom to fully vaccinate her according to a schedule with which
she's comfortable.

I know BF provides immune factors and is associated with less pneumomia,
etc.  Does anyone have information about breastfeeding's effect on any
specific vaccine preventable diseases?  (A CDC reference I have says it
has no passive immunity effect, but I suspect that's just because it hasn't
been
studied--may not be possible with American cultural breastfeeding since
most of these diseases don't occur in the first few months of life).

--
Anne Montgomery, M.D.
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