Dear Holly,

Just catching up (again) so this is a little late.  We had some
discussion a little while ago about MRSA and VRE.  Theoretically,
we do want to stop the spread of these resistant organisms and
could jump through many hoops trying to do so.  If the baby is very
premature or in an otherwise compromised state, then extra
precautions as far as separating from an infected mom may be
warranted.  But colonized moms will eventually pass these bugs on
to their babies, unless you are planning on separating them forever.
 Even then, the baby may have picked it up anyways.

Mom and baby can be isolated together to prevent spreading of the
organism to other moms and babies, but breastfeeding should
most certainly continue.  In certain cases of active bacterial
infections, the most conservative approach would be to keep baby
away for 24 hours while mom initiates antibiotic treatment and then
put mom and baby back together.  Very likely the best thing to do
would be to keep mom and baby together from the start and
concurrently treat with antibiotics.  The newest (5th) edition of
Lawrence has a nice chart in the appendix which outlines
recommendations for breastfeeding in the event of many common,
and not-so-common, maternal infections.

Since a mom and healthy newborn will be together once they leave
the hosptial anyways, what is the point of separating them in the
hospital for a few days?  It will only serve to interfere with the
commencement of breastfeeding which is the best way to boost
the baby's immune system to begin with.

It is, however, good infection control policy to keep mom and baby
isolated from others while in the hospital.  Unfortunately, MRSA
and VRE are becoming quite endemic in many hospitals and
infection control efforts seem to be failing, as are attempts to purge
these organisms from colonized individuals.
Warmly,
Sharon Knorr, BSMT, LLLL, IBCLC
Newark, NY (near Rochester) USA
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