Recommendations for breastfeeding during maternal infections

Abstract

Criança e do Adolescente da UFMG.Como citar este artigo: Lamounier JA, Moulin ZS, Xavier CC. Recomendações quanto à amamentação na vigência de infecção materna. J Pediatr (Rio J). 2004;80(5 Supl):S181-S188. AbstractObjective: To make a literature review on breastfeeding and maternal infectious diseases in order to contribute with knowledge and information that can aid the pediatrician to decide upon allowing infected mothers to breastfeed their babies or not. Sources of data:Lilacs and MEDLINE databases were searched for books, technical rules and articles on the issue of breastfeeding and infected mothers.Summary of the findings: Infected lactating mothers can transmit pathogenic agents to their infants. Although breastfeeding protects the child it can also be a dangerous source of infection. Maternal diseases caused by bacteria, virus, fungi and parasites may sometimes be transmitted via human milk. The literature points out that mothers infected with HIV and T-lymphotropic human viruses (type I) should not breastfeed. With other diseases a careful approach should be made, but, in general, breastfeeding is maintained. Conclusion:The mother who is exposed to infectious diseases may transmit pathogenic agents through the human milk, attention should also be made to milk from milk banks. The healthcare provider must take his/her decision upon suspending breastfeeding -or not, what can be distressful, once he/she has a fundamental role in promoting and stimulating breastfeeding.J Pediatr (Rio J). 2004;80(5 Supl):S181-S188: Human milk and infection, mothers infectious illnesses, maternal breast-feeding and infection. ResumoObjetivo: Revisão da literatura com o enfoque de amamentação e doenças infecciosas maternas, no intuito de contribuir com conhecimentos para decisões a serem tomadas pelo profissional de saúde. Fontes de dados:Informações foram obtidas em consultas que incluíram livros-texto, normas técnicas, artigos selecionados por meio de busca na base de dados Lilacs e MEDLINE, além de referências específicas.Síntese dos dados: Nutrizes com doenças infecciosas podem transmitir agentes patogênicos pelo leite materno para a criança. Embora a amamentação confira proteção à criança, ela pode também ser uma importante fonte de infecção. Doenças maternas causadas por vírus, fungos e agentes parasitários podem, em alguns casos, ser transmitidas via leite humano. Para mães com infecções pelo vírus da imunodeficiência humana e vírus T-linfotrópicos humanos tipo I, a recomendação é não amamentar. Nas demais doenças, é necessária uma avaliação cuidadosa, mas, em geral, na maioria dos casos, o aleitamento materno é mantido.Conclusões: Algumas doenças, principalmente as causadas por vírus, podem ser transmitidas durante a amamentação. O profissional de saúde, ao identificar uma nutriz com infecção viral ativa ou outra doença infecciosa, necessita tomar a decisão de suspender ou não a amamentação, o que pode ser um fato angustiante pelo seu papel fundamental na promoção e estímulo ao aleitamento materno.J Pediatr (Rio J). ...

Cells of human breast milk

“…However, perinatal guidelines from WHO and European and U.S. authorities state that women with HIV and HTLV should not breastfeed, and instead feed their babies with formula or banked breast milk. Women who are infected with CMV or herpes virus can still breastfeed infants born full-term [ 45 ]. A deeper understanding of this fundamental aspect of mammalian biology and the development of some method to block this route of infection requires a concerted approach by scientists, midwives and clinicians.…”

Hematological findings in children with brucellosis

“…There are case reports, however, that indicate probable transmission by lactation . Therefore, when brucellosis is diagnosed in a nursing mother, breast‐feeding should be stopped and the infant should be carefully evaluated . Family history is a risk factor for brucellosis and may indicate a common source of infection.…”

“…23,24 Therefore, when brucellosis is diagnosed in a nursing mother, breast-feeding should be stopped and the infant should be carefully evaluated. 25 Family history is a risk factor for brucellosis and may indicate a common source of infection. Screening of household members in an index case is important in order to identify additional unrecognized cases in order to lower morbidity.…”

Herpes simplex virus: Prevalence in placental tissue and incidence in neonatal cord blood samples

“…Transmission of HSV‐2 to the newborn can occur by transplacental hematogenous spread, during delivery or in the postnatal period [Kimberlin et al, ; Lamounier et al, ], even despite suppressive antiviral therapy [Pinninti et al, ]. This transmission can cause ocular and cutaneous lesions, meningoencephalitis, fetal malformations [Kimberlin, ; Straface et al, ], or disseminated infection [O'Riordan et al, ; Kimberlin, ; Arai et al, ; Straface et al, ].…”