Table 3.
Breastfeeding issues for selected maternal infections
| Organisma | Predominant modes of transmissionb | Usual timing of infectionc | Evidence for transmission in breast milk | Clinical significanced |
|---|---|---|---|---|
| Bacillus anthracis (anthrax) | Contact—animals, animal products, cutaneous lesions; airborne | NA | None | BF/BM; cover lesions; medications for therapy and prophylaxisf |
| Borrelia burgdorferi (Lyme disease) | Arthropod | NA | DNA by PCR; no reports of illness in infants | BF/BM |
| Candida spp | Contact | Postnatal (colonization, susceptible infants) | Contact with breast, not breast milk | BF/BM |
| Dengue viruses (1–4) | Mosquito | NA | None | BF/BM |
| SARS-associated coronavirus | Contact; droplet | NA | None | BF/BM |
| Toxoplasmosis gondii | Animal-borne; soil, fecal-oral | Congenital | None | BF/BM |
| Treponema pallidum (syphilis) | Body fluids; blood | Congenital, perinatal | None | Delay BF/BM 24-hr after initiating maternal therapy; empiric treatment of infant |
| Vaccinia virus (smallpox vaccine) | Contact; possibly airborne | NA | One case report, contact with breast lesion | BF/BMe |
| Variola virus (smallpox) | Contact; airborne | NA | None | Avoid BF/BM; separation PI |
| West Nile virus | Mosquito; blood | NA | One case report (no illness in infant) | BF/BM |
This is a selected, limited list intended to consider some important organisms that cause infection in the neonate or infant and possible issues related to breastfeeding and breast milk.
Abbreviations: BF, breastfeeding; BM, expressed breast milk; NA, not applicable; PCR, polymerase chain reaction; PI, period of infection; SARS, severe acute respiratory syndrome.
Organisms that cause various clinical illnesses in the infant and the mother; specific illnesses are too numerous to list.
For breastfeeding and non-breastfeeding situations; does not include all possible or reported modes of transmission (airborne, body fluids, contact, droplet, food-borne).
Does not include all possible times of transmission. If “NA,” the timing of infection is not associated frequently with pregnancy, delivery, or neonates and infants.
Notes the appropriateness of breastfeeding or use of breast milk when the mother has an infection with that specific organism.
Refer to reference [99].
Refer to the text for more explanation.