The summer months in the United States mean vacations from school, leading to more family time for camping, hiking, biking, and just playing around in the back yard. Along with the fun comes sunburn, bee stings and bug bites – along with the worry about disease carrying creepy crawlies. Though the recent spotlight has shown on mosquitos and Zika, Lyme disease is still a concern in some parts of the US.
Spread by infected black-legged ticks (sometimes called deer ticks or western black-legged ticks), Lyme disease is a bacterial illness that starts with a fever, headache, fatigue, swollen lymph nodes, and achy joints. But the telltale symptom is rash (which has a distinctive bullseye appearance) at the site of the bite. If the infection is not treated, it can spread to the joints, heart and nervous system. (Keep in mind not all ticks carry Lyme disease, but it can be difficult to distinguish between species unless you’re an entomologist!)
While parents do worry about their children being infected by a tick bite, moms who are breastfeeding have not only concern for their own health but worry about how Lyme disease might affect their nursling. An Internet search will show there’s lots of information out there – but it’s not always reliable.
The US Centers for Disease Control (CDC) reports that there have been no cases of Lyme disease transmitted through breastmilk. However, Dr. Thomas Hale (the leading researcher in breastfeeding pharmacology) says that the “antigenic material of the bacteria that causes Lyme disease, Borrelia burgdorferi, is transferred into human breastmilk” (see http://www.infantrisk.com/content/inaccurate-information-online-regarding-breastfeeding-lyme-disease). Whether or not this material has the potential to infect a breastfeeding baby is simply not known at this time.
Because of this, if you’ve been diagnosed with Lyme disease while breastfeeding, Hale suggests you should stop nursing until you have started antibiotics to treat the infection. The most common antibiotic for Lyme disease, doxycylcline, may not be the best choice for nursing moms – so searching for an appropriate alternative is important. You can pump to keep up your milk supply until your baby can resume breastfeeding, but you should not save the milk. If you have stored breastmilk, this would be the time to use it for your baby, otherwise you will need to use formula until you have started antibiotic treatment.
One worry is that baby was probably exposed before mom’s symptoms even started, so why this temporary interruption in feeding? Breastmilk provides so many immunities to babies, and likely provides antibodies mom is producing to the Lyme disease she has been exposed to. Discussing this with your own doctor and your baby’s doctor can help you make an informed decision.
Steps to prevent Lyme disease (whether you’re a breastfeeding mom or not) include:
- Avoid walking through brush and tall grasses
- Wear clothing that covers most of your body when outdoors
- Use an insect repellent containing DEET or Permethrin
- Check for ticks after returning indoors – be especially sure to check underarms, hairlines, belly buttons, knees and elbows, waistlines, and the groin area.
- Remove any ticks you find immediately. Use fine-tipped tweezers and pull upward quickly (without twisting or bending the tick). Clean the area with soap and water.
If symptoms develop in the following days or weeks, a doctor’s visit is appropriate. The sooner you start antibiotic treatment, the less interruption to breastfeeding.