To Susan Prevatt and other lactnetters:  The mom who never had chickenpox
may still be immune.  The incubation period for chickenpox is 10 to 21 days.
If she wants to, she could get varicella antibody levels drawn.  However,
even if she is susceptible and gets chickenpox, she is most contagious before
her lesions appear (so, unless she wants to isolate herself from her baby for
three weeks, she must realize that her chances of giving the baby chickenpox
are significant whether or not she continues to nurse).  But chickenpox has
no greater risk of complications in a 6 month old than an older child, so she
can be reassured (we only worry about babies in the immediate neonatal
period, if mom gets the rash 5 days prior until 2 days after delivery) Ruth
Lawrence's text is a good resource, as is the AAP's Red Book on Infectious
Diseases.  Her own antibodies will be present in the milk by 48 hours after
the rash.  As for contagiousness of the lesions, generally contagious until
scabbed over, usually 6 days after onset of rash.  If her lesions are on the
breast, she may wish to avoid nursing on that breast and pump from it.
Another question that may arise if she develops chickenpox is whether or not
she should take acyclovir, since she as an adult will likely have a more
severe case than the children.  No easy answer, since acyclovir is
concentrated in the milk, but the dose to baby (per Briggs) is estimated at
less than 10% of the dose given to newborns with varicella infection.  The
AAP considers acyclovir compatible with breastfeeding.  Good Luck, Alicia.
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