International Board of Certified Lactation Consultant (IBCLC) Practice Exam

What should a mother do if she has active varicella (chicken pox) lesions shortly after giving birth?

1. Continue breastfeeding as normal

2. Breastfeed only after lesions are healed

3. Pump and discard the milk until the lesions heal

4. Seek immediate medical assistance

The correct answer is: Breastfeed only after lesions are healed

The recommended approach for a mother with active varicella lesions shortly after giving birth is to breastfeed only after the lesions have healed. This recommendation is primarily based on the concern of transmission of the varicella-zoster virus through direct contact with the lesions or through the mother's milk, although the latter is less likely. Chickenpox is highly contagious, especially in its active phase, and although the risk of transmitting the virus through breast milk is considered low, there is still a potential risk of direct contact with the skin lesions during breastfeeding, which can lead to the infant contracting the virus. Therefore, to ensure the safety and well-being of the newborn, it is advised that breastfeeding be paused until the lesions are completely healed and the mother is no longer contagious. In contrast, continuing breastfeeding as normal, pumping and discarding the milk, or seeking immediate medical assistance do not adequately address the risks associated with active varicella lesions. Continuing to breastfeed poses a risk of transmission, and while medical assistance may be appropriate in some circumstances, it does not directly resolve the immediate concern regarding breastfeeding practices during an active infection.