Dear everyone,

I'm helping a family with twins wondering whether they can breastfeed or
not.  I know with healthy, full-term infants, a mother positive for CMV is
not an issue, but these are premies who have been sick but being discharged
soon.

The babies were born by cesarean at 32+2 who are now 43 days old (so
gestationally about 38 weeks). Birthweights were 1710 and 1720 grams.
 Current weights are 2500 and 2200.

They are in China so have been formula-fed in the NICU as they do not
accept breastmilk.  Moreover, the mother's milk was tested positive for
CMV, and she is a Hepatitis B carrier.

Both babies have had various issues during the hospitalization so far (NEC,
rotovirus）The smaller one was born with a hole in the stomach which was
repaired by surgery. After successful treatment, both are still in the
hospital.  The smaller one is being fed mostly by IV and tube, with very
small oral feeds (15ml), but the bigger one is being discharged tomorrow
and is finally healthy and bottle-feeds well. Both are on Neocate now. Both
babies have tested IgG positive.

Mom has been expressing 6 times a day, getting 1200-1300 ml of milk and
freezing it.

So, should they be home-pasteurizing the milk? Or can they breastfeed?  I
have not found a definitive answer with the resources I have on hand. At
what point or how does one judge whether and when it is safe for a
previously sick preemie to breastfeed on milk with CMV?

Thank you!

Sincerely,

Ivy Makelin
Beijing

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