MMR while nursing and before TTC - Page 2

[nia82]

I have no time to read the study but could someone tell me how recent the MMR vaccination of moms in those groups were? Thanks!

[slmommy]

nia82, the first page/citation only says the following. no word on prior vax.

Quote:

26 mothers seronegative for antibody to rubella virus (HAI titer, <1:8) and their infants were enrolled.

Mommatogray,

the first page of the study says of those 2 infants:

Quote:

Despite previous impressions concerning the lack of communicability of rubella vaccine virus from the postpartum-immunized mother to the breastfed neonate [1,2], two such infants, both of whose mothers received HPV-77 DE5 vaccine in the immediate postpartum period and showed serologic or clinical evidence of active rubella infection, have been recently identified [3,4].

The first infant shed rubella virus from the throat 12 days after maternal immunization; however, no antibody seroconversion was observed [3]. The other mother-infant pair exhibited a symptomatic illness 13 days after the mother was immunized postpartum; although the infant exhibited a fourfold increase in serum levels of anti-body to rubella virus between 14-28 days post-partum, no rubella virus was isolated from the infant or maternal milk [4].

It's not really saying anything "negative" other than it is possible (like 50% chance in this study) to pass virus/antigens through breastmilk. I don't know, some people may not like that idea. Personally I'd be more worried about the chance of arthritis/arthralgia, but to each their own!!

The Merck insert is the one which states that mild clinical presentation has been witnessed, but I couldn't find (and I didn't try that hard) these documents the Merck insert has for footnotes

Landes, R.D.; Bass, J.W.; Millunchick, E.W.; Oetgen, W.J.:  Neonatal rubella following postpartum maternal immunization, J. Pediatr. 97: 465-467, 1980. 

Lerman, S.J.: Neonatal rubella following postpartum maternal immunization, J. Pediatr. 98: 668, 1981. (Letter)on, J.x� it�� �f 5-467, 1980. 

Edited by slmommy - 2/10/12 at 3:46pm

[Taximom5]

MommatoGray, my gut reaction is that it would be better to nurse him if you get the MMR.

It's a live virus vaccine, and you would be shedding live virus cells for up to 3 weeks.  He could conceivably catch the viruses from you, even without nursing. Seems to me, nursing, even if you transmit some viral cells via breastmilk, would be the best way to handle this, as you would also be transmitting antibodies.

[MommatoGray]

Thanks for your responses.

Taximom5 - honestly I feel sick about the entire thing. I just don't know what to do. What you are saying does make sense. I was just thinking about leaving him with my Mom for a few days. But in further research it seems that most of the shedding starts at day 7. Oh man, I wish I was better equipped emotionally to figure this out! And he is progressingly so nicely, and mmr scares the crap out of me with the autism business. Would you just say no?

[slmommy]

Mommatogray,

 I don't want to tell you what to do, but I think anything bad happening, with either choice, is really slim chances. (Especially if you are not worried about you reacting to vax)

If the idea of going through one or more pregnancies without rubella immunity is going to stress you, get the MMR, pregnant women have enough to worry about as is. 

What are your plans about getting MMR for your son?

Even if you do pass virus/antigen through breastmilk, as long as your son does not have some immune issues, I don't think you need to worry. Did you find anything about the autism thing you mentioned? I think I saw someone saying on the other mothering thread about this that babies whose mothers were breastfeeding and received mmr, then had subsequent vaccination, had higher immunity levels than children who just had the shot.

I don't think you should stop nursing if you do it. Maybe just do some things to boost immune system, pick a time when there are no important things going on - if you should have any reaction, and then wait at least 3 months before trying to conceive.

Your son is much older than the babies in the study, they were newborns, his immune system is much more mature and pretty much at the age he would get MMR if you vaxed on schedule.

This thread has raised some questions for me... I'm not sure when/if I will get MMR for DD. But after reading the rates of arthritis/arthralgia reaction in women, maybe it would be better if she received it as an older child and before puberty...

[MommatoGray]

Thank you slmommy!

I am not sure when I want to get mmr for DS. To be honest I don't know which shots or when I plan to give them. Because I was not sure I just gave him nothing, until I could feel comfortable.

I found the study! Well one of them, and I have to admit by no means am I a researcher and I am probably not the best person to figure out its validity. Either way this study and one other (which I still can't find) made me question the safety of the shot while breastfeeding.

The nurse also said something which made me think - not sure if it would be true - she said that at least when you get it post partum baby is still getting antibodies from you. Although I am not immune to rubella I probably am to measles and that probably would have helped him. 

slmommy - what you are saying makes sense about your DD to be honest I wish when I got my travel vaxes they would of just given me another shot of mmr.

Hubs wants me to stop breastfeeding and then get the shot. He thinks it is too risky to do it while breastfeeding, considering we don't actually know the risk!

Too bad you need a degree in immunology in order to decide to vaccinate your kids!

Edited by MommatoGray - 2/11/12 at 11:56am

[slmommy]

Mommatogray, you might wanna edit your post to take that link off... maybe you can find the same study on another site? there was some issue on another thread here a while back, I guess that site has some hate literature or something on it... so while the study or report might be valid, i think mothering doesnt want links to that site listed here... ( i havent been to the site, but this was an issue in another thread... unfortunately they seem to have a lot of vax stuff, and it comes up right away in google! doesn't mean anything about the study, and the study is probably posted on other sites)

How long do you want to nurse for? I don't know how something like that would affect your nursing relationship... it seems like you *could* shed virus/antigens for quite a few days... and not necesarily only through breastmilk... so I don't know if it makes much sense to jeopardize nursing, if you wanna keep that up?? Maybe someone else knows more about that aspect.... 

Edited by slmommy - 2/11/12 at 12:38pm

[MommatoGray]

Thanks for the heads up! I took the link off.

I guess I will just keep up with my research

I was hoping to nurse till 2! And I don't really want to affect our nursing relationship.

[lokidoki]

Originally Posted by MommatoGray 

Again, thanks to all of you for your thoughts!

I think I have made some progress on trying to decide what to do. I am not too worried about my personal reactions to the vaccine. To be honest I have had a lot of shots, I travelled all around the world and of course got everything they recommended - before I knew better. Another thing is that I am not anti-vaccine I think I am more anti-schedule. Not sure what we will do in the future, just knew up till now I did not want to get any for DS.

So I digress....

I had a good friend who actually did my travel vaxes, I use to babysit all her children when they were young, house sat, dog sat, etc... The point is that I feel comfortable chatting with her and talking about her point of view. I can not believe that I had never thought of contacting her before this. Anyways, she called and we talked for over an hour. So I am still not convinced about vaxing him, that is what she pushed.

But I did come up with an idea and would really like to know your thoughts. She told me that yellow fever is not recommended during breastfeeding, but, if (you know the usual saying) the benefit outways the risk they will give it. And they tell the Mom to pump and dump for ten days.

So considering we are pretty sure mmr goes into breast milk then what if I pumped and dumped for a few days after. My concerns are the following:

1) He won't take a cup (obviously we would try before I went to do the shot)

2) He won't want to go back to nursing after he has had cup (my biggest concern)

3) He won't take the cup from me (which means mom would have to come stay)

4) Not sure how long to pump and dump (I know it says virus can shed via nose 7-28 days following vaccination)

My old boss (I was a nanny) left her 10 month old with me cause she had to go on a business trip. He took the cup just fine while she was gone and then went right back to nursing once she returned. He continued till just a few months ago until she weaned because she was pregnant and felt too tired to do it anymore.

My little man sure does love nursing, so my hopes would be that he would go back, my heart would break a little if he didn't.

I guess it comes down to the fact that I know myself and who I am, amd even though I could tell myself a million times that rubella is rare, I know I would worry my whole pregnancy. And I LOVE being pregnant and I really just want to enjoy it. Plus I know that we want 3+ kids so there hopefully be more pregnancies.  And if I did get it and something happened to baby I would never forgive myself

So, what do you think? Pump and dump and if I got the shot in March I was thinking to wait at least till July/August to TTC. Thanks so much for listing and for your help!!

I also have one more question:

I think that I don't really understand this. Is it so bad if he did get it, isn't that what we are all so upset about - our kids don't have the opportunity to contract "common" childhood illness? I can see that in a newborn it would be bad. But by the time I got the shot, DS would be 14 months.

Oh man, I don't know!! Even after writing all this I am still so unsure

I can tell you what I would do...but everything I have done for myself and my children has been based upon a) my research combined with b) my gut instinct ~ with a dash of the risks I feel I can take. Perhaps writing it down and seeing the pros/cons. For myself ~ I would not get the shot...but my stance is very much non-vax at all (not just against the schedule...I feel the vast majority of vaccinations are a waste). While I recognize there is a risk of being pregnant without immunity to Rubella...I think someone else posted a statement to the effect of ~ you have gone this far without getting it...what is to think that you will contract it in the first 3 months of being pregnant which is when it causes the birth defects? Just from reading about Rubella it is only moderately contagious and seems most contagious at the rash stage ~ which is beneficial because there is some actual "sign" that the child is sick with something odd.

So it is not like you are at risk of defects the entire 9 months of pregnancy.

Total side note to all of this ~ it is interesting to me that because there is a vax available we suddenly feel guilty if we opt on the side of "no vax" if something were to happen. If there were no vax available and you were to contract CRS during the first 3 months of pregnancy ~ would you still feel guilty? And on the other side of the coin ~ if you were to get the MMR vax and something happened to either this child or the unborn child ~ would you feel guilty? I am not saying this against you ~ because I have honestly found myself in the same boat with the vax decisions at times ~ and what I have told myself is ultimately there are risks on either side. It comes down to which risks am I willing to accept.

Hope that makes sense. I am not faulting you because it is a chance either way for sure ~ both sides of this come with accepted risk (either getting the vax or not getting the vax).