From Nina Berry: Hi there I assume you are thinking about prevention as well as treatment. My area of interest lies with infant and young child feeding. Including a programme to improve rates of exclusive breastfeeding amongst infants less than 6 months old and sustained breastfeeding for two years or more will ensure that infants and young children are not placed at unnecessarily high risk of contracting cholera or other infections. Also it will be worth thinking about how you will deal with infected mothers of breastfeeding infants/children. The best chance of survival for those infants will be continued breastfeeding. Mothers who are severely dehydrated may experience a temporary drop in milk production. Rehydration and frequent breastfeeding will rectify the situation quickly. Furthermore, the milk of an infected mother will be replete with antibodies and other immune defences that provide protection to the infant/child. (Of course protection is not complete and usual hygiene practices like hand washing prior to handling the baby are still important.) If a mother is truly to ill to breastfeed (that is, she is unconscious), then breastmilk from another mother will provide the baby his or her best chance of survival. This can be provided by a wet nurse. Feeding infant formula or other animal milks (including therapeutic milks) to infants damages the lining of their guts and alters both gut flora and pH, making them more susceptible to infections like cholera and shigella. Regards Nina

Dear All Just to add on the breastfeeding front and cholera, breastmilk has antibodies which shield the newborn from infections such as cholera. (thanks to Mary Lung'aho for sourcing these): See quotes below: " ... in children who are nursing, cholera is less likely to occur, presumably due to protection afforded by secretory antibody in mother's milk. http://bioinfo.bact.wisc.edu/themicrobialworld/Cholera.html (p.8) New research from a Brigham Young University/Harvard/Stanford research team discusses the possible molecular mechanisms by which breastfeeding transfers immunity to infants, and mentions cholera as one of the infections against which antibodies obtained through the mother's breastmilk offer protection in the infant's intestine while he builds up his own immunity. www.newswise.com/articlesview/545472 (Brigham Young University press release: 17 Oct 2008; article published in the Nov 1, 2009 Journal of Immunology). Regards Marie