Breastfeeding offers many benefits for both mother and infant, including essential nutrients and protective factors. New or expectant mothers often have concerns about the transmission of sexually transmitted infections (STIs) through breast milk. An STI is an infection passed primarily through sexual contact, caused by bacteria, viruses, or parasites. Informed decisions about breastfeeding require accurate information on potential transmission risks.
Understanding STI Transmission Risks Through Breast Milk
Some STIs can be transmitted to an infant through breast milk. Human Immunodeficiency Virus (HIV) can be transmitted if the mother is infected. Without antiretroviral treatment, HIV can pass to the infant via breast milk, though modern medication significantly reduces this risk, sometimes to below 1%. In regions with accessible safe formula, healthcare providers often advise against breastfeeding for mothers with HIV to eliminate transmission risk entirely.
Human T-lymphotropic virus type 1 (HTLV-1) can also be transmitted through breast milk. This retrovirus is primarily passed from mother to child via breast milk. The risk of transmission increases with breastfeeding duration, as prolonged exposure to HTLV-1-infected cells can lead to infection, especially as maternal antibodies decrease. A high viral load in the mother’s milk and blood also increases transmission likelihood.
Beyond the virus in milk, certain conditions can increase STI transmission risk. If a mother has active sores or lesions on her breast from Herpes Simplex Virus (HSV) or syphilis, direct contact during breastfeeding can transmit the infection. Cracked or bleeding nipples, which expose infectious blood, might increase transmission risk for infections like Hepatitis B (HBV) and Hepatitis C (HCV), even if not transmitted through milk itself. Monitoring breast health and practicing proper hygiene are important.
STIs Not Transmitted Via Breast Milk
Many common STIs are generally not transmitted through breast milk. Chlamydia, a bacterial infection, is not passed to the infant via breast milk. Gonorrhea, another bacterial STI, cannot be spread through breast milk. While these infections can transmit during childbirth, breastfeeding is safe if the mother is undergoing appropriate treatment.
Herpes Simplex Virus (HSV) is not transmitted through breast milk itself. Transmission typically occurs through direct contact with an active lesion, such as a sore on the breast or nipple. If a mother has active herpes lesions on her breast, avoid breastfeeding from the affected breast until the sores heal.
Human Papillomavirus (HPV) is highly unlikely to be transmitted through breast milk. Research indicates a low-to-no chance of passing HPV to a baby, with no conclusive evidence of transmission. Even when HPV is detected in breast milk samples, the risk of the baby contracting the virus is extremely low.
Hepatitis C (HCV) transmission through breast milk is extremely unlikely. Current recommendations state that maternal HCV infection is not a reason to avoid breastfeeding. However, if the mother has cracked or bleeding nipples, temporarily stop breastfeeding from the affected breast until healing, as blood-to-blood contact could pose a minimal risk.
Informed Decisions and Safe Practices for Mothers
Making informed decisions about breastfeeding with an STI involves proactive steps and open communication with healthcare providers. Regular STI testing, both pre-pregnancy and during pregnancy, is important for maternal and infant health. This allows for early detection and treatment, significantly reducing potential transmission to the baby.
Discussing STI status and concerns with a doctor, nurse, or lactation consultant is essential. These professionals provide personalized guidance based on individual circumstances, STI type, and treatment options. They can help weigh breastfeeding benefits against potential risks, clarifying if it is a suitable option or if alternatives should be considered.
For transmissible STIs, healthcare providers can outline specific risk reduction strategies if breastfeeding is chosen. This might involve strict adherence to antiviral medications, careful monitoring of viral loads, or managing active lesions to prevent direct contact. If breastfeeding is not recommended due to higher transmission risk, such as with HIV in resource-rich settings, providers can support mothers in using breast milk substitutes. Medical guidance is key for ensuring the safest feeding practices for infants.