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Question 728
Obstetric infection → Viral
Classification
Question
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Breastfeeding with maternal chickenpox
Question Stem
A woman develops chickenpox around the time of delivery and wishes to breastfeed. She is clinically well enough to do so, but has active chickenpox lesions close to one nipple. What is the most appropriate advice?
Options
A
Breastfeeding and expressed breast milk are both contraindicated until every lesion has healed
B
She should permanently stop breastfeeding from the affected breast
C
Express milk from the affected breast until the local lesions have crusted; expressed milk may be given to a baby receiving VZIG and/or aciclovir
D
Breastfeeding is permitted only after maternal VZV PCR becomes negative
E
Breastfeeding is contraindicated whenever maternal chickenpox occurs during pregnancy
Explanation
Women with chickenpox may breastfeed if they wish and are well enough. When active lesions are close to a nipple, milk should be expressed from that breast until the lesions have crusted over. The expressed breast milk may be given to a baby receiving VZIG and/or aciclovir.
Option Validity
A) maternal chickenpox does not require complete avoidance of breastfeeding or expressed milk.
B) avoidance of direct feeding from the affected breast is temporary while local lesions remain active.
D) a negative maternal VZV PCR is not specified as a prerequisite for breastfeeding.
E) breastfeeding is supported when the mother wishes to breastfeed and is well enough.
Further Reading
RCOG Green-top Guideline No. 13, Chickenpox in Pregnancy, section 6.3.