Is Maternal Tuberculosis compatible with breastfeeding? Do we have alternatives for Maternal Tuberculosis?

Maternal Tuberculosis

January 5, 2017 (Low Risk)

Whether a mother has been diagnosed and treated during pregnancy, or, diagnosed after birth: It makes no sense to wean the baby. On the first instance, the mother is not contagious any longer. On the second one, the baby has been already exposed to infection.

On cases when diagnosis were attained later than 15 days before delivery: Treat the mother, delay breastfeeding and infant-to-mother contact for 15 days. Meanwhile, milk must be pumped-out and given to the infant if the mother does not have active lesions on the breast.

Except on those rather rare cases of mammary tuberculosis abscesses, TB bacilli have not been found in breast milk. Anti-TB therapy is compatible with breastfeeding.

The infant must undergo a tuberculin skin test (PPD), chest x-Ray examination, and receive chemoprophylaxis (adjust isoniacid given to the child to the lowest dose since it is largely secreted into breast milk).

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Mother´s TBC

References

  1. Di Comite A, Esposito S, Villani A, Stronati M; Italian Pediatric TB Study Group. How to manage neonatal tuberculosis. J Perinatol. 2016Abstract
  2. Principi N, Galli L, Lancella L, Tadolini M, Migliori GB, Villani A, Esposito S; Italian Pediatric TB Study Group. Recommendations Concerning the First-Line Treatment of Children with Tuberculosis. Paediatr Drugs. 2016Abstract
  3. Malhamé I, Cormier M, Sugarman J, Schwartzman K. Latent Tuberculosis in Pregnancy: A Systematic Review. PLoS One. 2016Abstract Full text (link to original source) Full text (in our servers)
  4. Baquero-Artigao F, Mellado Peña MJ, del Rosal Rabes T, Noguera Julián A, Goncé Mellgren A, de la Calle Fernández-Miranda M, Navarro Gómez ML; Working Group on gestational, congenital, and postnatal tuberculosis, Spanish Society of Pediatric Infectious Diseases (PFIC). Guía de la Sociedad Española de Infectología Pediátrica sobre tuberculosis en la embarazada y el recién nacido (ii): profilaxis y tratamiento. [Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (ii): Prophylaxis and treatment]. An Pediatr (Barc). 2015Abstract Full text (link to original source) Full text (in our servers)
  5. Mittal H, Das S, Faridi MM. Management of newborn infant born to mother suffering from tuberculosis: current recommendations & gaps in knowledge. Indian J Med Res. 2014Abstract Full text (link to original source) Full text (in our servers)
  6. Red Book. Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, Red Book 2012
  7. Loto OM, Awowole I. Tuberculosis in pregnancy: a review. J Pregnancy. 2012Abstract Full text (link to original source) Full text (in our servers)
  8. Singh N, Golani A, Patel Z, Maitra A. Transfer of isoniazid from circulation to breast milk in lactating women on chronic therapy for tuberculosis. Br J Clin Pharmacol. 2008Abstract Full text (link to original source) Full text (in our servers)
  9. World Health Organization Stop TB Partnership Childhood TB Subgroup. Chapter 4: childhood contact screening and management. Int J Tuberc Lung Dis. 2007Abstract Full text (in our servers)
  10. Drobac PC, del Castillo H, Sweetland A, Anca G, Joseph JK, Furin J, Shin S. Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis. 2005Abstract Full text (link to original source) Full text (in our servers)
  11. Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN, Fujiwara P, Grzemska M, Hopewell PC, Iseman MD, Jasmer RM, Koppaka V, Menzies RI, O'Brien RJ, Reves RR, Reichman LB, Simone PM, Starke JR, Vernon AA; American Thoracic Society, Centers for Disease Control and Prevention and the Infectious Diseases Society. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med. 2003Abstract Full text (link to original source) Full text (in our servers)
  12. American Thoracic Society; CDC; Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep. 2003Abstract Full text (link to original source) Full text (in our servers)
  13. Tran JH, Montakantikul P. The safety of antituberculosis medications during breastfeeding. J Hum Lact. 1998Abstract
  14. Dautzenberg B, Grosset J. [Tuberculosis and pregnancy]. Rev Mal Respir. 1988Abstract
  15. Snider DE Jr, Powell KE. Should women taking antituberculosis drugs breast-feed? Arch Intern Med. 1984Abstract