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Subject:
From:
Robert Cordes DO <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 23 Jan 1998 17:22:29 -0500
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During my peds residence (93-96) I was the primary care doc for an IgA deficient infant who was formula fed and in day care and of course always sick. I always wondered how much better he would have been if breastfeed.
Sory if I degress from the Lactnet appropriate discussion but I wanted to comment on some things fron Dayna Williams post.
-Your son had pertussis at 4 months! Hopefully no lasting problems.
-Titers to pertussis dont predict immunity, hence the problems with proving effectiveness of acellular vaccines in infants
-IgA coats all mucus membrains, respiratory,gut,urinary. Deficient individuals are at risk for infections at all these sites.
-very common tue, 1 in 600 of European decent. Half are asymptomatic
-often as the individual gets older IgA levels increase
-It is not important specifically to know if level is 0 or 6. Def is undetectable usually reported as <6
-Vaccines are OK!!!!!!  MMR and oral polio are OK!!!! With 1in 600 people we eventually give these vaccines to IgA def people withuot knowing. Also I have asked two peds infectious diease specialist who agree varivax (chicken pox) vaccine is OK to give
Sorry to get a little nuts but Im as pro vaccine as I am pro breastfeeding
-Antibiotics at first sign of respiratory infection? I guess one could. I was taught continues antibx prophylaxis for first two years
-Have parents screened? Why? If asymptomatic what are you going to do?
-Run IgG 2and 4 ? Agian what to do with results? In children normal values can be very low intereting is difficult. Replacind IgG in an IgA def person is very dangerous as with any blood produce anaphylatic rx can occur. An immunologist told me in relation to my patient that he would not replace IgG unless defiecent and sick enough to need a ventolator a few times a year.
I think Dayna did by far the best thing in prolonged breastfeding a child who really needed it.
-Dr Rob (can I use Dr and first name or is that reserved for elite Drs and must be earned first?)

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