I'm in the process of doing some literature review and writing about immunizations. I think the most important thing is true informed consent. I encourage full immunization but try to give parents full information including both the public health and individual health aspects of the vaccines. I also encourage parents not to lump all vaccines as "good" or "bad" but to look at each disease and each vaccine individually. For example, I have one mom who has chosen to delay most vaccinations but has given her baby Hemophilus vaccine since that particular disease is a risk for her child right now. She plans to wait until she is old enough for the acellular pertussis vaccine (18 months), and we are still negotiating about the other ones. This is a child who is fully breastfed and cared for at home, so I don't feel that the timing of vaccines is as urgent as for a child in day care, although as I said, I encourage mom to fully vaccinate her according to a schedule with which she's comfortable. I know BF provides immune factors and is associated with less pneumomia, etc. Does anyone have information about breastfeeding's effect on any specific vaccine preventable diseases? (A CDC reference I have says it has no passive immunity effect, but I suspect that's just because it hasn't been studied--may not be possible with American cultural breastfeeding since most of these diseases don't occur in the first few months of life). -- Anne Montgomery, M.D. [log in to unmask]