Last update: Oct. 20, 2016
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.
Infection caused by several species of Brucella (B. melitensis, B. abortus and B. suis, rarely B. canis) by consumption of fresh milk products from infected animals or close contact to them. Apart from the transplacental and perinatal transmission, inter-human transmission is extremely rare (Nemenqani 2009).
There are very few publications on transmission through breast milk being not able several of them to state it categorically since they could not exclude a transplacental transmission or from other sources of infection (supplementation to infants with non-human fresh milk is frequent in endemic areas (al- Nahedh 1994), failure to have a positive culture for Brucella in the breastmilk (Lubani 1988, al-Eissa 1990, Varon 1990, Barroso 1998, Palanduz 2000, Palanduz 2005, Arroyo 2006, Ceylan 2012, Calik 2012). Others found that transmission was transplacental or at delivery (Lubani 1988, Aydın 2013, Ozturk 2015). Some others commented that the infant was weaned, but did not point out to whether the child was infected or not. (Nemenqani 2009, Ozturk 2015).
The only one reported case of Brucella infection of a 11-mo-old infant, Brucella melitensis was isolated from a breastmilk culture (Tikare 2008).
Also, in rare cases of breast abscess due to Brucella infection, breastmilk cultures were positive for Brucella melitensis; two mothers breastfed their infants, but the author failed to mention the clinical condition or evolution of infants (Nemenqani 2009).
Any way, the fact is that the incubation period lasts from 3 to 4 weeks (range 1 week to several months) and then until the first symptoms appear that again is followed by a time period to get a diagnosis which is often delayed, it is probably worthless withdrawing breastfeeding. Hence, it seems operationally more effective the initiation of treatment to the mother, test the infection status of the infant, follow him up and treat the child if indicated (al-Eissa 1990).
Treatment of Brucellosis, which can include Doxycycline, TMP-SMX, Rifampicin, Streptomycin and Gentamicin, is compatible with breastfeeding (See specific info on these antimicrobials).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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