DearCustomer

As long as neither the child nor the mother-in-law are suffering an active infection, and so long as the mother-in-law's Absolute Neutrophil Count (ANC) is at or above 1500/microL, I would feel comfortable with the two interacting ... with one caveat. If the mother-in-law's ANC is expected to drop lower than 1000/microL, or as we term this "nadir," then I think the interaction would best be postponed until all can be assured that the ANC will remain at or above 1500/microL, for the safety of both mother-in-law and baby.

The risks of infection transmission goes both directions, so a low ANC predisposes the mother-in-law to infection risks from bacteria and viruses within the baby's environment and on the baby, while the baby's underdeveloped immune system is not prepared to fight off the types of infections that occur in, and could come from, a patient with low ANC.

The ANC is calculated from the CBC (complete blood count) as follows:
ANC = Total WBC (cells/microL) x percent (PMNs + bands) ÷ 100

The Terminology:

PMNs = Polymorphonuclear Leukocytes = Neutrophils = Granulocytes = Segmented Neutrophils

Bands = Premature Neutrophils = Premature PMNs = Band Forms

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If this is confusing, the physician's office can tell you the ANC based on the last CBC, which should be recent. The physician can also advise if he or she believes the ANC is expected to fall below 1500 in the near future. In some cases of chemotherapy for certain types of lung cancer and for certain chemo drugs, the ANC can be boosted using granulocyte (yet another name for a neutrophil) colony stimulating factor, or G-CSF.

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IN SUMMARY:

• If the mother-in-law's ANC is greater than or equal to 1500 cells/microL ... and it's expected to remain above that level, the interaction is acceptable and safe for both the baby and mother-in-law.
• Routine precautions such as thorough hand washing and sanitary practises are recommended.
• If the baby has an infection or fevre, I would recommend waiting for everything to clear before reassessing the potential for interaction according to the mother-in-law's ANC, and expected ANC.
• If the mother-in-law is with fevre, actively infected, or with a mildly low ANC (less than 1500), moderately low ANC (less than 1000), or severely low ANC (less than 500), I would advise against interaction until everything is treated and the ANC returns at or above 1500 cells/microL.

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XXXXX XXXXX, MD