Lyme Disease and Breastfeeding

Adapted from an original article in e-Blender, the Area Leader Letter for LLL of New York, USA.

In the Northern Hemisphere, spring and summer weather brings fun opportunities for families. After being cooped up in the house for the winter, they can go 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. Parents are often especially concerned about ticks, since a variety of ticks can carry a version of the B. burgdorferi bacteria which causes Lyme disease, along with various other organisms. Tick borne illnesses can occur at any time when the ground is not frozen including spring, summer and fall (autumn).

Black-legged and deer ticks often carry the B. burgdorferi bacteria in North America, while it is most frequently transmitted in Europe and Asia by the sheep or castor bean tick. Lyme disease has also been reported in South America, Africa and Australia, although its prevalence has not been confirmed in some places.

Some Leaders may receive calls from breastfeeding mothers who have been exposed to the disease and been told to stop breastfeeding by their doctors. Can Lyme disease be transmitted by breastfeeding? What information can we share with mothers?

Nursing mothers diagnosed with Lyme disease can continue breastfeeding, unless infant exposure to the appropriate antibiotics is contraindicated for unusual reasons such as drug interaction or infant drug allergy.

The Centers for Disease Control and Prevention (CDC) in the United States says:

“There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic that’s safe for use when breastfeeding.” (CDC, 2016).

“in case of infection, the mother will not be diagnosed until the symptoms appear between 7 and 14 days from the beginning of the infection, so it does not make sense to interrupt breastfeeding and it could even be contradictory since breastfeeding strengthens the baby’s immune system.” (e-lactancia, 2018).

In Breastfeeding and Maternal Illness Part 1 Canadian pediatrician Jack Newman explains:

“breastmilk is providing the baby with many other immune substances (lactoferrin, lysozyme to mention only 2 of many) which help the baby fight off any microbe to which he was exposed. And the antibodies and other substances form a barrier on the mucous membranes of the baby’s body which protect the baby by preventing the microbes from entering his body (the inside of the gastrointestinal tract is considered outside the body). This barrier prevents bacteria and viruses from entering into the baby’s body and is an important way the antibodies and other immune factors protect the baby against infectious agents.” (Newman, 2018).

Treatment of Lyme disease should begin as soon as a diagnosis is made. Doxycycline is an antibiotic used in the treatment of Lyme disease and is compatible with breastfeeding.

“Many mothers taking doxycycline for Lyme disease are told to stop breastfeeding. In fact, this is not necessary. About 20% of the doxycycline is bound to calcium (from the milk) and thus does not get absorbed by the baby. Amoxicillin is also used to treat Lyme disease and is compatible with continued breastfeeding, without question” (Newman, 2014).

If a mother was infected with Lyme disease before or during pregnancy, or if the baby or child was also bitten by a tick, it may be necessary for the baby/child to be treated for Lyme disease. Parents should be encouraged to discuss these possibilities with their child’s doctor.

If you are contacted with concerns about Lyme disease, encourage sharing up to date resources with the mother and baby’s health care provider. For more information, be sure to contact the Professional Liaison department in your Area.

Lyme In 80+ Countries Worldwide, Lyme Disease Association, Inc. https://www.lymediseaseassociation.org/about-lyme/cases-stats-maps-a-graphs/940-lyme-in-more-than-80-countries-worldwide

Newman, Jack. Breastfeeding and Maternal Illness Part 1, ibconline.ca, 2018

Maternal Lyme Disease, e-lactancia, 2018 http://www.e-lactancia.org/breastfeeding/maternal-lyme-disease/product/

Lyme Disease Frequently Asked Questions (FAQ), Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2017 https://www.cdc.gov/lyme/faq/index.html

Newman, Jack and Pitman, Teresa. Dr. Jack Newman’s Guide to Breastfeeding. Pinter & Martin, 2014. Print.

Burrascano, J. J. (2008). Advanced Topics in Lyme Disease: Diagnostic Hints and Treatment Guidelines for Lyme and other Tick-Borne Illnesses. Retrieved from Bethesda, MD www.ilads.org

Mary Francell and her husband Howard are the parents of three children, ages 26, 22 and 19. She has been an LLL Leader for over 20 years and is a Contributing Editor for Leader Today. Mary is an International Board Certified Lactation Consultant (IBCLC) in private practice and formerly served as Area Professional Liaison for LLL of Georgia, USA.