Breast milk offers numerous benefits for infant health, providing essential nutrients and antibodies. While breastfeeding is encouraged, parents should understand the transmission of certain infections, including sexually transmitted infections (STIs), sometimes referred to as STDs. Accurate information is critical for informed decisions about infant feeding.
STDs Transmitted Through Breast Milk
Certain sexually transmitted infections can be transmitted through breast milk, posing a risk to the infant. These include Human Immunodeficiency Virus (HIV) and Human T-lymphotropic Virus (HTLV).
HIV is present in breast milk and can be passed from a mother to her infant through breastfeeding. Without intervention, the risk of transmission is significant. In settings with safe alternatives, mothers with HIV often avoid breastfeeding. For mothers on antiretroviral therapy (ART) with an undetectable viral load, the risk is considerably reduced to less than 1%, though not entirely eliminated.
HTLV, specifically HTLV-1 and HTLV-2, can also be transmitted through breast milk. Transmission primarily occurs via breastfeeding. Longer breastfeeding durations and a high proviral load are risk factors for infant infection. Infants infected with HTLV can face potential long-term health issues.
STDs Where Breastfeeding Is Often Possible
For several STDs, breastfeeding is generally safe, or transmission through breast milk is not the primary concern. Specific medical management or precautions are necessary to protect the infant.
Hepatitis B (HBV) is typically not transmitted through breast milk. Infants born to mothers with HBV should receive the hepatitis B vaccine and Hepatitis B Immune Globulin (HBIG) at birth. This treatment makes breastfeeding safe by eliminating transmission risk.
Hepatitis C (HCV) transmission through breast milk is rare and usually does not contraindicate breastfeeding. Breastfed infants do not have higher rates of hepatitis C. If cracked or bleeding nipples are present, temporarily stop breastfeeding from the affected breast until it heals, expressing and discarding milk to maintain supply.
STDs Not Transmitted Through Breast Milk
Many STDs are not transmitted directly through breast milk, though direct contact with active lesions can pose a risk. Understanding these distinctions helps manage breastfeeding safely.
Herpes Simplex Virus (HSV) is not transmitted through breast milk. However, active lesions on the breast or nipple can transmit the virus through direct contact. To prevent transmission, avoid breastfeeding from the affected side until lesions heal, expressing and discarding milk to maintain supply.
Syphilis is also not transmitted through breast milk. Active syphilis lesions (chancres) on the breast or nipple pose a direct contact risk. If present, avoid breastfeeding from the affected breast until they heal. Treatment for the mother is essential.
Gonorrhea and Chlamydia are not transmitted through breast milk; transmission to infants typically occurs during vaginal birth. Human Papillomavirus (HPV) is likewise not transmitted through breast milk. While HPV DNA has been detected in some breast milk, transmission to the infant through breastfeeding is very low, and benefits generally outweigh theoretical risks.
General Guidance for Breastfeeding Mothers
For breastfeeding mothers, prioritizing health involves proactive measures and collaboration with healthcare professionals. Comprehensive prenatal and postnatal STD screening is important for all pregnant and breastfeeding individuals. Early detection allows for timely intervention and management, reducing risks to both mother and infant.
Mothers should discuss their STD status and breastfeeding plans with their doctor, pediatrician, or lactation consultant. Individualized medical advice is important, as recommendations vary based on the specific infection and mother’s overall health. Adhering to prescribed treatments can significantly reduce transmission risk and protect maternal health.
Practicing general hygiene, such as handwashing, and avoiding direct contact with active lesions are effective preventive measures. These practices empower mothers to make informed decisions about breastfeeding that align with their health status, medical guidance, and available resources.