Summer weather brings fun opportunities for mothers and their babies. After being cooped up in the house for the winter and spring, they can get outside to take walks, enjoy picnics in the park and swim. With these activities come considerations such as sun protection, getting babies to nap while on the go, breastfeeding in public and bug bites. One bite in particular that worries breastfeeding mothers is the bite of the deer tick, the most common carrier of the bacteria that causes Lyme Disease. How can we as Leaders advise breastfeeding mothers who think that they might have been exposed to this bacteria?
However, because of the seriousness of the effects of Lyme Disease and lack of hard data about its transmission, other sources suggest taking a more conservative approach. Although no infants have been reported to have contracted Lyme Disease from their mother’s milk, and there are no reports of the actual bacteria being found in human milk, the antigenic material of the bacteria has been found, and it is not known whether this is harmful to the baby (Muscianese et al. 2016). Because “[t]he lack of adequate information on transmission of B. burgdorferi via breast milk cannot be taken as proof that it is not occurring,” some doctors advise that it would be prudent to consider withholding breast milk at least until therapy for Lyme Disease has begun (Lawrence 2016).
A breastfeeding mother should begin treatment as soon as she is diagnosed with Lyme Disease. “The recommended antibiotic for the treatment of Lyme Disease in non-pregnant adults is doxycycline. However, doxycycline is not ideal for breastfeeding mothers due to its long half-life and greater uptake into human milk than alternative treatments. Other antibiotics such as amoxicillin, cefuroxime, clarithromycin, and azithromycin are preferred since their levels of transmission into breastmilk have been measured and are minimal.” (Muscianese et al. 2016). After prenatal or postnatal exposure, babies should be closely monitored for a year and treated for Lyme Disease if they develop any of the symptoms such as the bulls-eye rash that are commonly seen in infected people. The mother should be encouraged to speak to her healthcare provider about continuing surveillance of her breastmilk for viable B. burgdorferi during that time (Lawrence 2016). Heat treating at 48 degrees Celsius for thirty minutes has been shown to kill the bacteria (Cruz 2008), but there is no protocol for this treatment for human milk.
In conclusion, when a Leader is talking to a mother who has been diagnosed with Lyme Disease, there is no easy answer. The mother should be made aware of the possibility that the bacteria that causes Lyme Disease could be transmitted via her breastmilk and that genetic material from the bacteria has been found in human milk when she is considering her options. She should also be encouraged to seek out a breastfeeding supportive doctor or a doctor who specializes in the treatment of Lyme Disease. If a mother does choose to withhold breastfeeding until she has started antibiotic treatment, the Leader should share information with the mother about pumping to maintain her supply and talk with her about how to appropriately feed a breastfed baby in a way that is supportive of having the baby come back to the breast after the break.
Bonyata, Kelly, IBCLC. "Breastfeeding and Lyme Disease • KellyMom.com."KellyMomcom. N.p., 29 July 2011. Web. 11 May 2016.
Cruz, A. R., Moore, M. W., La Vake, C. J., Eggers, C. H., Salazar, J. C., & Radolf, J. D. (2008). Phagocytosis of Borrelia burgdorferi, the Lyme disease spirochete, potentiates innate immune activation and induces apoptosis in human monocytes. Infection and immunity, 76(1), 56-70.
Lawrence, Ruth A., MD, and Robert M. Lawrence, MD. Breastfeeding: A Guide for the Medical Profession. 8th ed. N.p.: Elsevier, 2016. Print.
"Lyme Disease Frequently Asked Questions (FAQ)." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 20 Apr. 2016. Web. 11 May 2016.
Muscianese, Laura, MS, and Thomas Hale, PhD. "Inaccurate Information Online Regarding Breastfeeding with Lyme Disease | InfantRisk Center."Inaccurate Information Online Regarding Breastfeeding with Lyme Disease | InfantRisk Center. Infantrisk.com, n.d. Web. 11 May 2016.