TABLE 2.
Viruses transmitted through breastfeeding
| Virus family | Virus | Demonstrated transmission through breastfeeding | Uncertain/ low risk of transmission through breastfeeding | Current recommendations | References |
|---|---|---|---|---|---|
| Retroviridae | HIV | X | High-income settings with access to clean water and affordable replacement feeding (infant formula): to not breastfeed, regardless of ART and maternal viral load. Resource-limited settings: to breastfeed exclusively for the first 6 mo of life and continue breastfeeding for at least 12 mo, with the addition of complementary food. These mothers should be given ART to reduce risk of transmission through breastfeeding. (CDC) |
[103,69,[114], [115], [116], [117], [118], [119], [120], [121], [122], [123], [124], [125], [126], [127], [128], [129], [130], [131], [132], [133], [134], [135], [136], [137], [138], [139], [140], [141], [142], [143], [144], [145], [146], [147], [148], [149], [150], [151], [152], [153], [154], [155], [156], [157], [158], [159], [160], [161], [162], [163], [164], [165], [166], [167], [168], [169],271,272] | |
| HTLV | X | Mothers should NOT breastfeed or only feed expressed breast milk to their infants. (CDC) | [11,12,33,37,103,[170], [171], [172], [173], [174], [175], [176], [177], [178], [179], [180], [181], [182], [183], [184], [185], [186], [187], [188], [189], [190],273,274,275,405] | ||
| Herpesviridae | HCMV | X | There are no recommendations against breastfeeding by mothers who are HCMV-seropositive. However, infants born at a gestational age of <30 wk and <1500 g who acquire HCMV from breast milk may be at risk of developing a late-onset sepsis-like syndrome. The potential benefits of human milk versus risk of HCMV transmission should be considered when deciding about the breastfeeding of very premature babies by mothers known to be HCMV-seropositive. (CDC) | [14,15,[43], [44], [45],49,50,52,[191], [192], [193], [194], [195], [196], [197], [198], [199], [200], [201], [202], [203], [204], [205], [206], [207], [208], [209], [210], [211], [212], [213], [214], [215], [216], [217], [218], [219], [220], [221],276,277,[278], [279], [280], [281],282,283] | |
| HSV-1/HSV-2 | X (Through breast lesions) | Mothers with active lesions on the breast should temporarily stop breastfeeding from the affected breast (CDC) | [[222], [223], [224],284,285] | ||
| VZV | X | Continue to breastfeed. In the case of a potential risk of perinatal VZV, expressed breast milk can be given to a newborn, if there are no skin lesions on the breasts during the period of the mother's infectivity. (CDC) | [286] | ||
| Coronaviridae | SARS-CoV-2 | X | Continue to breastfeed (CDC, WHO, UNICEF, AMB, EMBA, UENPS, SIN) | [73,[225], [226], [227], [228], [229], [230],[287], [288], [289],290,291] | |
| Flaviviridae | YFV | X | Vaccination is recommended, if vaccination is indicated as suitable for a breastfeeding woman, and travel cannot be avoided or postponed (WHO) | [231,232,292,293] | |
| DENGUE | X | Continue to breastfeed (CDC) | [75,76,233,234] | ||
| WNV | X | Continue to breastfeed (CDC) | [235,294] | ||
| ZIKV | X | Continue to breastfeed (WHO) | [[79], [80], [81], [82],[236], [237], [238], [239], [240], [241], [242], [243], [244], [245], [246], [247],295,296] | ||
| HCV | X if the nipples and/or surrounding areola are cracked and bleeding | There is no documented evidence that breastfeeding spreads HCV. However, HCV is spread by infected blood. Therefore, if the HCV-positive mother’s nipples and/or surrounding areola are cracked and bleeding, she should stop nursing temporarily. (CDC) | [85,86,[248], [249], [250], [251], [252], [253], [254], [255], [256], [257],297] | ||
| Hepadnaviridae | HBV | X | All infants born to HBV-infected mothers should receive hepatitis B immune globulin and the first dose of hepatitis B vaccine within 12 h of birth. There is no need to delay breastfeeding until the infant is fully immunized. (CDC) | [107,[258], [259], [260], [261], [262], [263], [264],298] | |
| Hepeviridae | HEV | X | Continue to breastfeed. Women with a symptomatic HEV infection, especially with high viral loads of viremia, should not breastfeed. (Chibber, 2004) | [299] | |
| Picornavirus | HAV | X | Continue to breastfeed | [87,265] | |
| CBV3 | X | Continue to breastfeed | [88] | ||
| Papillomaviridae | HPV | X | Continue to breastfeed (LactMed® + Biblio) | [112,266,91] | |
| Filoviridae | EBOLA | X | Suspend breastfeeding (WHO) | [92,93,95,[267], [268], [269]] | |
| Hantaviridae | ANDV | X | Continue to breastfeed | [97] | |
| Matonaviridae | RuV | X | Continue to breastfeed (LactMed® + Biblio) | [99,270,300,301] |
ADNV, Andes virus; CVB3, coxsackievirus B3; DENV, dengue virus; EBOV, Ebola virus; HAV, hepatitis A virus; HBV, hepatitis B virus; HCMV, human cytomegalovirus;
HCV, hepatitis C virus; HEV, hepatitis E virus; HPV, human papilloma virus; HSV-1/HSV-2, herpes simplex virus types 1 and 2; HTLV-I/HTLV-II, human T-lymphotropic virus; RuV, Rubella virus; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TTV, TT virus; VZV, varicella-zoster virus; WNV, West Nile virus; YFV, Yellow fever virus; ZIKV, Zika virus.
Notes: references include English articles with full-text available. Clinical studies, observational studies and in vitro studies were considered.