{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T23:27:16Z","timestamp":1777159636494,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hemolytic disease of the fetus and newborn (HDFN) is characterized by destruction of fetal\/neonatal red blood cells (RBCs) secondary to maternally derived antibodies, which are typically thought to be passively acquired via placental transfer. Few cases have examined the possibility of HDFN mediated by maternal antibodies passively transferred via breast milk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe two cases of persistent HDFN in infants potentially mediated by passively acquired antibodies via maternal breast milk. We discuss supporting and refuting evidence that may account for this possibility and describe testing methodology illustrating how maternal alloantibodies can be detected in breast milk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In both cases, anti\u2010D antibodies were detected in maternal breast milk. One patient experienced a significant decrease in anti\u2010D plasma titer from 64 to 4 dilutions following 2\u2009weeks of breastfeeding cessation. The other patient experienced a resolution of anemia without breastfeeding cessation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a paucity of data regarding the lifespan of passively acquired RBC antibodies in neonatal circulation, with significant variation noted between passively acquired IgG based on studies utilizing intravenous immunoglobulin compared to studies of maternally\u2010acquired antiviral IgG antibodies. While our data do not definitively implicate passive transfer of alloantibodies in breast milk as a mediator of HDFN, they do illustrate the need for further investigation into the mechanisms and kinetics of passively acquired antibodies in neonatal circulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17548","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:17:19Z","timestamp":1694711839000},"page":"2188-2196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Passive transfer of alloantibodies through breast milk as a mediator of hemolytic anemia"],"prefix":"10.1111","volume":"63","author":[{"given":"Elizabeth","family":"Abels","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-9685","authenticated-orcid":false,"given":"Jeremy W.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Prior","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura C.","family":"Willets","sequence":"additional","affiliation":[{"name":"Pediatric Clinical Nutrition Yale New Haven Hospital  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nataliya","family":"Sostin","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1785-2245","authenticated-orcid":false,"given":"Christopher A.","family":"Tormey","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1246-8957","authenticated-orcid":false,"given":"Thomas C.","family":"Binns","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.146"},{"key":"e_1_2_8_3_1","unstructured":"Dean L.Hemolytic disease of the newborn [Internet]. Blood Groups and Red Cell Antigens [Internet]. National Center for Biotechnology Information (US).2005[cited 2023 Feb 5]. Available from:https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK2266\/"},{"key":"e_1_2_8_4_1","unstructured":"Nationwide Children's Hospital.Hemolytic Disease of the Fetus and Newborn.https:\/\/www.nationwidechildrens.org\/conditions\/hemolytic-disease-of-the-fetus-and-newborn-hdfn#:~:text=HDFN%20is%20a%20temporary%20(short issues%20in%20babies%20with%20HDFN. 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