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In immune thrombocytopenic purpura (ITP) there are autoantibodies of the IgG class against platelets that cross the placenta during pregnancy, attacking the fetal platelets and causing the newborn to develop transient ITP until the antibodies received from the mother are eliminated in the first 4-6 weeks of life.
These newborns should be monitored clinically and analytically during these first weeks of life. They may present a more or less severe clinical condition requiring or not treatment with transfusion of platelets, immunoglobulin or corticoids.
Publications on antiplatelet antibodies in breastmilk are rare and under-documented (Hauschner 2015, Kelemen 1978) and cases of infants whose platelet count was not normalized until breastfeeding stopped are anecdotal and not well proven (Hauschner 2015, Martin 1984, Macpherson 1975).
There have been reports of newborns with ITP where breastfeeding did not affect the platelet count at all (Meschengieser 1986).
Nor has it been possible to prove intestinal absorption of these antibodies by the infant (Lawrence 2016 p594).
Breastfeeding would be facilitated in cases where the mother has been treated with early splenectomy (Rezk 2018).
Several experts and expert consensus consider that breastfeeding should not be contraindicated in the case of maternal ITP (Rezk 2018, Meschengieser 1986), not even when receiving treatment with corticosteroids (Miyazawa 2015).
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