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Infection caused by the bacillus Mycobacterium tuberculosis.
The World Health Organization and most specialized medical associations recommend continuing breastfeeding in all cases of maternal tuberculosis (TB). There is no need for mother-infant separation except in the case of multi-resistant TB. The mother should wear a mask during the first days of treatment and the infant must be diagnosed and administered prophylaxis with isoniazid or TB treatment (Mittal 2014, WHO 2007 and 1998).
According to Red Book 2012 and cited in Lawrence 2016 p427:
- Non-active maternal TB, without active lung lesions in the lung does not contraindicate breastfeeding or warrant separation.
- Active TB with pulmonary lesions requires separation and interruption of direct breastfeeding (but expressed breastmilk can be administered) up to 15 days after starting the treatment or analysis of negative sputum (Di Comité 2016, Baquero 2015). (Although it is most likely that the infant will already have been exposed and what is required is diagnosis and prophylaxis with isoniazid or simultaneous treatment to that of the mother)
- Only in the rare case of tuberculous mastitis are both direct breastfeeding and the administration of expressed milk contraindicated.
Except in cases of TB mastitis, Mycobacterum tuberculosis is not transmitted through breastmilk (Click 2018).
Breastfeeding is possible in mothers treated for multi-resistant TB (Drobac 2005).
The amount of isoniazid that the infant receives through breastmilk is negligible (Garessus 2019, Singh 2008).
Drugs for the treatment of TB are compatible with breastfeeding (Blumberg 2003, ATC 2003, WHO 2002, Tran 1998, Dautzenberg 1998, Snider 1994) and transfer in such small amounts that there is no need to modify the dose of the treatment or prophylaxis of TB of the infant (Partosch 2018, Blumberg 2003, ATC 2003).
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