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Section 2. Recommendations for Care of Children in Special Circumstances
HUMAN MILK
Transmission of Infectious Agents via Human Milk
BACTERIAMastitis and breast abscesses have been associated with the presence of bacterial pathogens in human milk. In general, infectious mastitis resolves with continued lactation during antimicrobial therapy and does not pose a significant risk for the healthy term infant. Breast abscesses occur rarely and have the potential to rupture into the ductal system, releasing large numbers of organisms, such as Staphylococcus aureus, into milk. Temporary discontinuation of breastfeeding on the affected breast for 24 to 48 hours after surgical drainage and appropriate antimicrobial therapy may be necessary. Even when breastfeeding is interrupted on the affected breast, breastfeeding may continue on the opposite (unaffected) breast.
Women with tuberculosis who have been treated appropriately for 2 or more weeks and who are not considered contagious may breastfeed. Women with tuberculosis disease suspected of being contagious should refrain from breastfeeding or any other close contact with the infant because of potential transmission through respiratory tract droplets (see Tuberculosis, p 678). Mycobacterium tuberculosis rarely causes mastitis or a breast abscess, but if a breast abscess caused by M tuberculosis is present, breastfeeding should be discontinued until the mother no longer is contagious.
Expressed human milk can become contaminated with a variety of bacterial pathogens, including Staphylococcus species and gram-negative bacilli. Outbreaks of gram-negative bacterial infections in neonatal intensive care units occasionally have been attributed to contaminated human milk specimens that have been collected or stored improperly. Human milk fed to infants from women other than the biologic mother should be treated according to the guidelines of the Human Milk Banking Association of North America. Routine culturing or heat treatment of a mother’s milk fed to her infant has not been demonstrated
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