>I think the statement about not BF 2 hours pre & post oral polio
>immunization is one of those "urban myths."  Riordan & Auerbach say
>it is OK (with ref) and BF Answer Book says same with a ref from  AAP
>Committee on Infectious Disease 1994.  Red Book 2000 makes no
>mention on any delay in BF.

I am a sceptic by nature and don't usually fall for urban myths. So I
listened to the tape of Professor Lars Hansen again today and even
transcribed sections. He was mainly talking about how the breastfed baby
will respond better to various vaccines, and why. The main reason the
vaccine is enhanced is because of the mother's (and even grandmother's)
history of exposure/immunisation. But he did say "not always, and especially
not to live vaccines if they haven’t taken it into regard that the
antibodies are in the milk and the baby has just been breastfed, then they
will neutralise the vaccine". At the end someone asked him to elaborate on
this, and this is what he said:

"If the baby has just been breastfed and you give the oral polio it will be
neutralised, so it should be two or more hours after the breast-meal before
they give it. This recommendation is based on the very early observations in
Africa of Sabin’s live vaccine because it didn’t work, and it took them a
while to understand that it related to breastfeeding. Yes, you have to wait
another two hours after the vaccine but its worth it – at that time (until
they worked out the problem) 2% of African children contracted poliomyelitis
and were really impaired. I am very disturbed by the WHO proposal that they
should give the oral polio on the day of birth because then breastfeeding
should be started and there is an enormous concentration of polio antibodies
in the early colostrum. I understand why its done, because you have the
mother available, but I wouldn’t rely on it a bit."

That doesn't sound like an urban myth to me. The truth is that polio has
been as good as eliminated in most parts of the world, so it wouldn't matter
a lot if the vaccine was neutralised (note - this problem does not apply to
inactivated polio vaccine by injection). But if you lived in Africa, parts
of Asia, and (I think) parts of South America, and you had been vaccinated
against polio yourself, you would probably not want even a 2% risk of polio
for your breastfed child. This is a disease WHO is working to eliminate
completely, as they did smallpox.

Ros Escott BAppSc IBCLC
Tasmania, Australia

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