Last update July 17, 2023

Maternal Lyme disease

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

An infectious disease caused by different species of spirochetes of the genus Borrelia (B burgdorferi and others). They are transmitted to humans by the bite of several species of ticks of the genus Ixodes. The tick needs to be connected at least 36 hours in order to transmit the disease. The transfer of Borrelia to breast milk has not been documented. (Red Book 2021-24 p483, CDC 2017, Shapiro 2014, Mylonas 2011, Cooper 2004)

In one study, Borrelia DNA was found in milk samples from two symptomatic patients, but none of the babies contracted the disease (Schmidt 1995). The presence of DNA does not imply that there are live, virulent spirochetes.

In another study of 7 mothers with Lyme disease who breastfed (5 symptomatic), no harmful effects were found in the babies. (Ziska 1996)

The majority of authors and health organizations maintain that breastfeeding is compatible with Lyme disease, since there is no evidence of spirochetal transmission through milk. (CDC 2017, Newman 2014, Shapiro 2014, Mylonas 2011, Cooper 2004)

Moreover, 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. (KellyMom 2017)

Although the general consensus is that breastfeeding should continue if a mother has Lyme disease, some authors recommend waiting to breastfeed until after starting or completing treatment. (Hale 2017 p.582, Lawrence 2016 p.225 y p.462)

When diagnosed in a breastfeeding mother, both the infant and mother should be treated. Doxycycline is the treatment of choice in the mother and is not contraindicated during breastfeeding. Amoxicillin, cefuroxime, ceftriaxone or macrolides may be preferred in children. (Wormser 2006)

Other authors prefer antibiotics such as amoxicillin, cefuroxime, clarithromycin and azithromycin in breastfeeding mothers since their transmission levels to breastmilk have been measured and are minimal. (Hale 2017 p.583, Prescrire 2015)

See below the information of these related products:

  • Amoxicillin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Azithromycin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ceftriaxone Sodium ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Cefuroxime ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Clarithromycin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Doxycycline (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Lyme Disease Vaccine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Maternal Lyme disease is also known as


Maternal Lyme disease belongs to this group or family:


  1. (Red Book). AAP. Kimberlin DW, Barnett ED, , Lynfield R, Sawyer MH eds. Red Book: 2021-2024. Report of the Committee on Infectious Diseases. 32th ed. Elk Grove Village, - 2021
  2. Bonyata K. Breastfeeding and Lyme Disease. 2017 Full text (link to original source) Full text (in our servers)
  3. Centers for Disease Control and Prevention (CDC). Lyme Disease Frequently Asked Questions (FAQ). Can Lyme disease be transmitted through breast milk? 2017 Full text (link to original source) Full text (in our servers)
  4. Centros para el Control y la Prevención de Enfermedades (CDC). Preguntas frecuentes sobre la enfermedad de Lyme. ¿Puede la enfermedad de Lyme transmitirse por medio de la leche materna? 2017 Full text (link to original source) Full text (in our servers)
  5. [No authors listed] Lyme disease. Recognising and treating erythema migrans. Prescrire Int. 2015 Oct;24(164):247-9. Abstract
  6. Shapiro ED. Clinical practice. Lyme disease. N Engl J Med. 2014 Abstract
  7. Mylonas I. Borreliosis during pregnancy: a risk for the unborn child? Vector Borne Zoonotic Dis. 2011 Abstract
  8. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelman RB. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006 Abstract
  9. Cooper JD, Feder HM Jr. Inaccurate information about lyme disease on the internet. Pediatr Infect Dis J. 2004 Abstract
  10. Ziska MH; Giovanello T; Johnson MJ; Baly J. Disseminated Lyme Disease and Pregnancy. 9th Annual International Scientific Conference on Lyme Disease & Other Tick-Borne Disorders, Westin Copley Plaza Hotel, Boston, MA, April 19-20, 1996 Full text (in our servers)
  11. Schmidt BL, Aberer E, Stockenhuber C, Klade H, Breier F, Luger A. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis. Diagn Microbiol Infect Dis. 1995 Abstract

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