Nature Medicine | Spoonful of Medicine

Breast isn’t always best

breastpump.jpgYesterday, the New York Times reported that while items like acne creams and denture adhesive are eligible for tax breaks under the new US health care law, breast pumps are not. Breast-feeding boosters like La Leche League are, naturally, up in arms, but the US Internal Revenue Service says that the pumps do not fall under the umbrella of preventative medicine, since breast milk is primarily nutrition.

To counter the IRS, breast-feeding advocates point to research showing that breast-feeding transfers essential antibodies from mother to child. There’s also research suggesting that bacteria in mother’s milk plays a key role in building up a healthy community of intestinal microflora.

But in certain circumstances, breast-feeding can be a vector for harmful microbes as well. In February, the US Centers for Disease Control (CDC) reported the case of a mother in Brazil who, after she received a yellow fever vaccine, passed the virus to her infant through her milk. Hepatitis B virus (HBV) has been detected in the milk of HBV-positive mothers, though it’s unclear if the virus can actually be transmitted through breast-feeding; the most common method of mother-to-child HBV transmission is during delivery itself. If a Hepatitis C-positive mother has cracked or bleeding nipples, she runs a higher risk of transmitting the virus to her infant. UNICEF estimates that if an HIV-positive mother breast-feeds, she’ll pass the virus to her child 5 – 20% of the time.

It’s worth noting that another US government agency, the Transportation Security Administration, classifies breast milk as ‘liquid medication’, which is why mothers are allowed to bring more than three ounces of it on a plane.

Image by planet _oleary via Flickr Creative Commons


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