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To the editor,

 

Your quick look at breaking news entitled "Breastfed baby has West Nile virus" (Medical Post October 15, 2002), was a little too quick a look, without thinking of the implications of what was said.  The fact of the matter is that though it is possible, even likely, that the virus was passed in the milk, this is not an indication to stop breastfeeding in a mother who is infected with this virus (unless the severity of the illness makes continued nursing impossible).  Unfortunately, that the mother should not continue breastfeeding is the conclusion that too many physicians will make.

 

In the first place, the viremia almost certainly occurs before the mother is even aware that she is sick, and only when there is viremia is it possible for a virus to get into the milk.  Thus the baby would have been "infected" before it was rational (but incorrect) to stop breastfeeding.  Secondly, the most important sentence was buried in the quick look.  In fact, the issue is that the baby remained healthy.  Not only that, it is possible he was even immunized against the virus.  This is what breastfeeding is about, at least some of what it is about.  Breastfeeding doesn't prevent infection, it helps prevent the illness which may occur as a result of infection.  This is what we want, isn't it?  This is why we promote immunizations, isn't it? 

 

The Medical Post article, in itself not so bad, but coming hard on the heels of the completely irresponsible CNN and New York Times coverage should have made this point.  We already have too many mothers being told to stop breastfeeding, unnecessarily, for maternal illness, maternal medication use, and infant illness. 

 

Jack Newman, MD, FRCPC

Toronto