CDC H1n1 guidelines seperate mom & baby

[Lisoula]

http://www.cdc.gov/H1N1flu/clinician_pregnant.htm

So am I reading this right that they're recommending newly delivered moms with flu symptoms to only express their milk and have a "healthy" person feed it instead of direct breastfeeding???? Nothing like sabotaging the breastfeeding relationship from the very start!

[ErikaS57]

No matter how careful we are, when someone in the house gets sick, we all do. So, if I get swine flue, I figure they've already been exposed so I'll just nurse away...

[2lilsweetfoxes]

Not to mention, the mama has already started to make antibodies which would pass the placenta and get into the breastmilk. Really, it might stand to reason that the entire family--except for the baby--falls ill.

[AFWife]

Originally Posted by ErikaS57

No matter how careful we are, when someone in the house gets sick, we all do. So, if I get swine flue, I figure they've already been exposed so I'll just nurse away...

This. Unless they're putting the baby in a place with separate air and making sure everyone that touches him/her scrubs up operating room style it's not worth it.

[5xmom]

This one is a bit better - http://aapnews.aappublications.org/c...s.20091012-1v1

[Lisoula]

Originally Posted by 5xmom

This one is a bit better - http://aapnews.aappublications.org/c...s.20091012-1v1

I need to bring this one to the attention of the higher-ups where I work.

[Youngfrankenstein]

Around here, the Cleveland Clinic is the medical god. They were recommending a mandatory 48 separation of mom and babe for any mom who had flu symptoms. I just am very sad about that.

[Lazy Gardens]

Originally Posted by Lisoula

http://www.cdc.gov/H1N1flu/clinician_pregnant.htm
So am I reading this right that they're recommending newly delivered moms with flu symptoms to only express their milk and have a "healthy" person feed it instead of direct breastfeeding?

Looks like they are recommending breastfeeding to me, and providing breast milk from a bottle only if necessary to prevent the virus from spreading from an infected mom to her baby, whether newly or oldly delivered.

"Infants who are not breastfeeding are more vulnerable to infection and hospitalization for severe respiratory illness than infants who are breastfeeding. Women who are not ill with influenza should be encouraged to initiate breastfeeding early and feed frequently. Ideally, babies should receive most of their nutrition from breast milk. Eliminate unnecessary formula supplementation, so the infant can receive as much maternal antibodies as possible"

"Infants are thought to be at higher risk for severe illness from novel influenza A (H1N1) infection and very little is known about prevention of novel H1N1 flu infection in infants. If possible, only adults who are not sick should care for infants, including providing feedings. The risk for novel influenza A (H1N1) transmission through breast milk is unknown. However, reports of viremia with seasonal influenza infection are rare, which suggests that the risk of virus crossing into breast milk is also probably rare. Sick women who are able to express their milk for bottle feedings by a healthy family member should be encouraged to do so. "

The CDC comes out 100% firmly on the side of breastfeeding and you are complaining because they point out that a hacking, sneezing, achy mom just might make her baby sick during breastfeeding where they are sharing a lot of the same air.

Looks like they have analyzed the risk and decided that breast milk is important and the risk of getting it from the milk is slim, and pointing out that there is a way to get milk to the kid for the week or so that mom is hacking, sneezing, and achy.

Nothing like sabotaging the breastfeeding relationship from the very start!

Nothing like keeping the infected and contagious mom from directly infecting her baby! Mommy is sick, which means there are no antibodies yet to whatever is making mommy hacking, sneezing, and achy.

In a couple of weeks, the anti H1N1 influenza antibodies will be there and baby can benefit from them.

[Lazy Gardens]

Originally Posted by Youngfrankenstein

Around here, the Cleveland Clinic is the medical god. They were recommending a mandatory 48 separation of mom and babe for any mom who had flu symptoms. I just am very sad about that.

That's just enough time to run the lab tests to find out what the mom has.

Here's the scary part of H1N1:

In contrast with run-of-the-mill "seasonal flu" viruses, the H1N1 virus exhibits an ability to infect cells deep in the lungs, where it can cause pneumonia and, in severe cases, death. Seasonal viruses typically infect only cells in the upper respiratory system.

Babies don't handle pneumonia very well, and better a 48-hour separation just in case than a newborn in NICU on a respirator. Unlike "filial imprinting" in ducks and geese, bonding between mother and child doesn't have a critical window.

[Little Bear's Mama]

Originally Posted by Lazy Gardens

In a couple of weeks, the anti H1N1 influenza antibodies will be there and baby can benefit from them.

What is your resource for the time frame in which antibodies might be available to the baby? Are you only including targeted immune cells or immune factors in general?

Originally Posted by Lazy Gardens

Unlike "filial imprinting" in ducks and geese, bonding between mother and child doesn't have a critical window.

Imprinting aside, the evidence is clear that mother and infant bonding IS important--from birth onwards. The CDC guidelines do not take bonding into account, and a lot of hospitals are following them to the letter or even being more stringent. I know of a mother whose baby was in the NICU. She did not have swine flu, but only "flu-like symptoms". Not only was she not allowed to see her baby for a week, but the NICU nurses also refused to feed her expressed breastmilk to her baby. She was asked to pump and dump for a 7 days, regardless of improvement in her symptoms. I've also heard of mothers being separated from their babies after birth, and not being allowed to make contact until after they leave the hospital. So, while the CDC guidelines do clearly support breastfeeding, they also aren't clear enough to prevent issues like I described above.

The good thing is that the AAP guidelines take the needs of the baby and mother into account. They do not encourage separation, but do urge parents to take reasonable precautions. I heard that the CDC was considering revising their guidelines, and I sincerely hope that they do.

[mamazee]

Home birth looks better and better all the time.

[haydn'smommy]

Yikes!!! This babe had flu at 9days old. My toddler had it and 2 days later baby and I developed symptoms. Our ped told me the best thing I could do was nurse that baby like crazy and get those good antibodies in him. I can't imagine having baby exposed (and if mom is showing symptoms and baby is within 3 ft of her it will have been exposed) and not getting baby that important colostrum and antibodies. Wow.

[Pirogi]

Originally Posted by Little Bear's Mama

What is your resource for the time frame in which antibodies might be available to the baby? Are you only including targeted immune cells or immune factors in general?

This. Answer?

[Gentle~Mommy :)]

You would think the CDC knows what they are doing lol

I would just nurse too.

[dollysods]

At one hospital in my area, a mother recently had suspected swine flu (cough, fever) as well as another reasonable possible source of fever. She was kept away from her baby for 48 hours after initiation of treatment of Tamiflu or until no longer febrile/coughing, whichever came second. She was pumping and the nurses gave the baby expressed milk. She was not allowed to hold or see her baby at all, even with a mask. I think the cdc is being a bit short-sighted in that in my experience, most mothers who are not able to breastfeed in the hospital have a less successful breastfeeding experiencee unless they are very motivated. I hope that they have taken the possible morbidity associated with not breastfeeding into the equation when making this recommendation because I would guess that much of the time that will be the unintended effect. I plan to bring this up at our next baby-friendly hospital meeting.

[Kappa]

I had the full blown flu, secondary bacterial infection of the throat and ear infection last March, I was laid out for a full 10 days, nursed straight through and my baby never had a single symptom.

[phreedom]

We have the 48 hour separation, encourage mom to pump if she wants to breastfeed as well. The problem is...vaginal deliveries are often discharged after 48 hours, which means that the mom may have not had a chance to directly nurse the baby before she is discharged, therefore any possible issues with latch may not have had a chance to be assessed and prevented. This is assuming the baby is not admitted to NICU. At least with the NICU babies the mom can come in after 48 hours and get a chance to nurse and be observed by the LC. Not so much if she and the baby are just discharged home (no not all moms need to be helped by the LC...but many appreciate it) We have to apply this to moms who show "flu-like symptoms" which could range from "really, really sick" to " sniffles and cough"

HOWEVER...if the mother wishes to have the infant with her regardless she may. BUT the infant is to room in 24/7. As it will be considered isolation. We are not to bring the infant to the well baby nursery so mom can "get some rest, take a shower or visit with company" The baby and mom will have a nurse that can help and watch the baby in room so mom can go to the rest room or take a quick shower, but it is highly encourage that mom have someone in there to help her with the baby. This is explained to the mom often before she gives birth. This is not to punish her, but it is to minimize contact with the other babies. We also try to minimize the staff dealing with isolation patients. Usually when we have this, only one nurse is assigned to the mom and baby. Obviously this is not a perfect system, but it's the best they could come up with for this.

Our hospital still has a "full service" nursery. The babies don't HAVE to go there, but they are admitted under nursery services and have their own nursery nurse separate from the mom's nurse. Most parents opt to send their babies to the nursery at some point during their stay even for a few hours.

In NICU it's a different thing all together. Babies are admitted there and don't leave until they go home. If parents are suspected of having flu, they are discouraged from visiting for 48 hours at least until test results come in. If they don't have the flu, they have to wear a mask and have been fever free for at least 24 hours. We encourage pumping if they are unable to BF and we do NOT dump the milk.

[Lisoula]

Originally Posted by Lazy Gardens

Looks like they are recommending breastfeeding to me, and providing breast milk from a bottle only if necessary to prevent the virus from spreading from an infected mom to her baby, whether newly or oldly delivered.


The CDC comes out 100% firmly on the side of breastfeeding and you are complaining because they point out that a hacking, sneezing, achy mom just might make her baby sick during breastfeeding where they are sharing a lot of the same air.

Looks like they have analyzed the risk and decided that breast milk is important and the risk of getting it from the milk is slim, and pointing out that there is a way to get milk to the kid for the week or so that mom is hacking, sneezing, and achy.



Nothing like keeping the infected and contagious mom from directly infecting her baby! Mommy is sick, which means there are no antibodies yet to whatever is making mommy hacking, sneezing, and achy.

In a couple of weeks, the anti H1N1 influenza antibodies will be there and baby can benefit from them.

I totally disagree. If the mom is showing flu-like symptoms, she already IS producing antibodies. My main point of this thread, though, which you clearly missed, is that it WILL INDEED sabotage a breastfeeding relationship if the infant is NOT ALLOWED TO LATCH and is being bottle fed!!!!!! Although highly debatable, nipple-confusion does indeed occur, quite frequently, and keeping a newborn separated from its mother for the first 48 hours or so could very well lead to an infant who never latches at all.

[Cativari]

Are these "flu" cases being confirmed or just assumed because of symptoms? One of my BIG problems with this whole H1N1 thing is a lot of them aren't confirmed (lab tested positive). There are over 70 different (from what I remember) viruses that cause flu like symptoms and aren't the flu. What I'm afraid is happening is alot of misdiognoisis of these other viruses and a lot of unneeded interuptions in nursing relationships because hospitals don't understand what they are doing (you know increasing health risks to the child and mother later in life or how much they could potientally be costing the health care system if mother as a result of their actions doesn't have a successful bfing relationship with the infant).