>The next question regarding hep B and bf starts by >quoting the Red Book of the >AAP 's stance on hepatitis B and then goes on to >say: >Dr. Ryan states,..." Certainly, mothers in >developing countries where >formula is not available should breast-feed. In the >United states, a mother >who strongly desires to breastfeed her infant can >probably do so with minimal >or no risk. " ... >And Dr. Mishell states,... "However, if there is any >chance that a >potentially fatal disease could be transmitted to the >infant by >breast-feeding, no matter how uncommon this >occurrence, I would recommend >that a woman with hepatitis B utilize another source >of providing nutrition >to her infant." >I spent two hours writing an e-mail to this journal, if >any would like to >further comment their e-mail address is >[log in to unmask] This is free >monthly journal for NP's that I receive. >Sincerely, > Christine Betzold FNP, MSN, CLE Christine, This Dr Ryan/Dr Mishell debate sounds familiar. I Believe it is from a journal called the Courtlandt Forum in which readers send questions to an editorial board. When the Hep B question was first asked, Dr Mishell an OB/GYN discouraged breastfeeding. I and other physicians wrote in and disagreed citing the Red Book. Dr Ryan is Michael Ryan DO a pediatric infectious disease specialist who also does a lot of general pediatrics. Dr Ryan agrees with the Red Book statement but it appears the Clinical Advisor didn't fully quote him. I was going to write the Courlandt Forum again on this issue but you'll note Dr Mishell said "another source" he didn't say formula. Still maybe I should have written again. BTW Dr Ryan kind of "stole" me out of a FP residency and was my residency advisor. When I Emailed him that I was surprised my now weaned 2 y/o didn't get rotavirus this year but thought it might be b/c he had breastfed thought 3 rotavirus seasons Dr Ryan's response was: "Smart" -Rob Rob Cordes, DO ,FAAP, FACOP Wilkes Barre, PA mailto:[log in to unmask] *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html