Maternal Lyme disease

An infectious disease caused by different species of spirochetes of the genus Borrelia. 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 (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 bacteria. 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 and 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 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).

• Amoxicillin (Very Low Risk)
• Azithromycin (Very Low Risk)
• Cefuroxime (Very Low Risk)
• Clarithromycin (Very Low Risk)
• Doxycycline (Low Risk probable)
• Lyme Disease Vaccine (Very Low Risk)

Synonyms

• Borrelia burgdorferi infection
• Lyme borreliosis