I have received a phone call from the mother of premature twins,
born at 30 weeks gestation. Routine blood tests during pregnancy had shown
she had CMV antibodies, in other words she had had CMV at some earlier date.
She did not have it during pregnancy. After the birth, she had a CMV attack.
At that point her milk was tested, and was found to have a very high
quantity of the virus, while in her blood it was inactive. (This is what I
was told by the mother. I am not a doctor - as is probably clear to those of
you who are - so I may be getting this a bit garbled.)
        She was told it would be dangerous to give premature babies her
milk. Only one of the babies on a single occasion received 30 cc. of colostrum.
        The babies were born in October, and now they have reached their due
date. The mother had been told that at this point it would be OK to start
breastfeeding, but now another doctor has advised her it would be better not
to breastfeed at all. She has been expressing her milk, but naturally she is
getting very discouraged.
        I asked the advice of an Italian doctor, who told me that an article
has just appeared in Italian pointing out that transmission of CMV through
breast milk increases after the first month, especially if the baby has not
already received antibodies through the colostrum. In fact in Lawrence (p.
485) it says: "Virus excretion into colostrum and milk is much less frequent
during the first few weeks following delivery. Reactivation of CMV in the
breast appears to peak between 2 and 12 weeks. This is the time when
transplacental antibody levels in the infant are waning. CMV infection can
become established even in the presence of maternally acquired antibody,
although the outcome is less severe."
        So my question is this: As the mother did not breastfeed initially,
and the babies have not received her colostrum or the antibodies via her
milk, is it OK if she now starts breastfeeding 10 weeks after the birth?
Supposing the babies do get CMV? What are the symptoms? Is it very dangerous?
                        Thank you,
                                Anna Lowenstein
                                Zagarolo, Italy