Alloantibody in Breast Milk???

[emergency room]

Hi,

I was wondering if anyone know if alloantibody can be found in breast milk? I was having a discussion with my medical director today concerning a prenatal patient with anti-E of a titer 128. The patient is concerned whether she is able to breast feed her baby. If I am not wrong, the baby was born last week with HDFN. Any ideas or articles related to this issue?

[galvania]

Well it is certainly possible to transmit IgG antibodies in breast milk although I have not heard of anyone actually looking for IgG antibodies against red cell antigens. But then, how would the breast milk pass from the baby's stomach to it's red cells?

[Malcolm Needs ☆]

Well it is certainly possible to transmit IgG antibodies in breast milk although I have not heard of anyone actually looking for IgG antibodies against red cell antigens. But then, how would the breast milk pass from the baby's stomach to it's red cells?

Quite!

[EDibble]

Well it is certainly possible to transmit IgG antibodies in breast milk although I have not heard of anyone actually looking for IgG antibodies against red cell antigens. But then, how would the breast milk pass from the baby's stomach to it's red cells?

Exactly my point. The antibodies would not survive the stomach acid, much less pass into the blood stream.

Beth

[Abdulhameed Al-Attas]

Yes, as Galvania has stated,Normally, acid in the stomach is strong enough to break down and destroy immunoglobulin antibodies. However, the baby's stomach acid does not break down the antibodies in the mother's breast milk. This is because the mother's mammary (breast) glands package immunoglobulins with a protective substance. This allows the immunoglobulin to reach the infant's intestine, where it is absorbed into the bloodstream. Once the immunoglobulins enter the bloodstream, they move throughout the body, searching for any foreign substances that may harm the body.

[EDibble]

Yes, as Galvania has stated,Normally, acid in the stomach is strong enough to break down and destroy immunoglobulin antibodies. However, the baby's stomach acid does not break down the antibodies in the mother's breast milk. This is because the mother's mammary (breast) glands package immunoglobulins with a protective substance. This allows the immunoglobulin to reach the infant's intestine, where it is absorbed into the bloodstream. Once the immunoglobulins enter the bloodstream, they move throughout the body, searching for any foreign substances that may harm the body.

Of course. Sorry about that. I will think it through better the next time.

[carolyn swickard]

We did have a mother with a strong Anti-B (IgG component) and the Pediatrician did not let her breast feed her second B pos child with HDN. Along with all the proper precautions/treatments for the infant in the Special Care Nursery, this child did not need an exchange transfusion as the earlier B pos sibling had to have.

I really hadn't thought about it either way, but mothers are supposed to breastfeed so their infants get all the good antibodies to help them through their early months before their own immune system takes over - that would hardly be useful if the antibodies didn't survive to do the job.

Thanks for the information -

(Quote:This is because the mother's mammary (breast) glands package immunoglobulins with a protective substance. This allows the immunoglobulin to reach the infant's intestine, where it is absorbed into the bloodstream. Once the immunoglobulins enter the bloodstream, they move throughout the body, searching for any foreign substances that may harm the body.)

[Mabel Adams]

But aren't most of the antibodies in breast milk IgA, the secretory antibody? Also, breast feeding is known to sometimes make jaundice worse. In the case of HDFN it may not have been about the antibody in the milk but whatever it is about breastfeeding that increases jaundice.

As an aside, there is, I think, I substance in breast milk than can be used to neutralize anti-I antibodies.