In a message dated 4/28/03 8:20:22 PM Pacific Daylight Time,
[log in to unmask] writes:


> From 1999, 5th edition, Breastfeeding - a guide for the medical profession
> by Ruth Lawrence MD, table E-1 p. 869:
>
> Breast abscess - discontinue ebm x 24 hrs after surgery; no bf x 24 hrs
>
> Endometritis/PID for group B strep - bf ok after 24 hrs of therapy; ebm ok.
>
> Haemophilus influenzae - bf after 24 hrs on therapy; may give ebm
>
> Mastitis - staph A - bf after 24 hrs of therapy; discard milk x 24 hrs
> Mastitis - group A strep - same as above
>

Laurie,
I do not have the 1999 ed. I have the 1994 and the only place I see a hold on
breastfeeding is when the infection is unknown and Mom to have 12 hours of
treatment before resuming nursing.  The Mom is to continue pumping though.

Recently someone asked about the booklet Dr. Lawrence produced for the DPH.
I had the booklet and I heard her presentation at ILCA and she did not make
the above recommendations.  There are rare exceptions when a mother and baby
need to be isolated away from each other, the few exceptions would be in the
newborn period and if the baby were premature.  Once they are home, the baby
is exposed prior to diagnosis.  The mother's milk will start to make
antibodies to the infection she is fighting and this is important for the
baby to receive.
You may want to call Dr. Lawrence and ask about these recommendations, and
get explanations.
I was thinking about a talk Dr. Hale gave and described the cellular membrane
in the breast similar to the brain and they have similar protective
properties.  Would this also hold in regard to infections in the body?
Rarely does an infection pass the blood brain barrier.  If any one has an
answer, would love to know.
Ann Perry RN IBCLC
Boston, MA

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