Dear Melissa: I've lent out my copy of Lawrence, but am reasonably sure that hepatitis A is not a problem with breastfeeding, presumably because mother's own antibodies are passed along with the virus. As for Immune globulin, that's simply IgG antibodies to hep A. Maternal IgG antibodies to various diseases normally pass through to babies, giving what is known as "passive immunity", which decreases the severity or even prevents disease in the baby. Immune serum globulins are given to provide people of all ages exposed to diseases a similar kind of passive immunity. Most immunoglobulins in human milk are secretory IgA, which acts locally at the gut's mucous membrane. I'm not sure if the serum immune globulins from the shot are secreted into human milk, although some IgG transmission has been documented. If they were, they would either be destroyed in the baby's gut or get into its bloodstream, where they would simply provide the same function for the baby. I'll check for references to be certain, but there seems to be no reason for concern. As for how the restaurant knows which foods are contaminated, generally it's raw shellfish, but contamination of any food by an infected employee who did not use proper hygiene (i.e. did not wash their hands after going "potty") is another possibility. I'm sure the local health department is investigating the source. If she ate contaminated food, it might be advisable for her to get the shot. Although hep A causes no long-term liver damage (unlike B and C), it can be devastating while one has it, and that could interfere with her nursing. Alicia. [log in to unmask]