Does milk contain maternal bacteria?

[Penny4Them]

I was just dxed with Lyme Disease. I've had it for about 5 years, so I was PG with my now 10 mo DS, who is still my nursling. I'm worried about the possibility he may have Lyme, or if he doesn't have it, that he might contract it from my milk since my disease was mostly off the radar for the past 2 years (no symptoms).

I'm going on a BFing safe ABX (per Hale's site), but still I'm so worried. I know I'll be giving him Lyme antibodies too, but is BM kind of like urine, in that it takes stuff out of the body that is not good for mother? Is BM made to support baby's health more than the mothers? I know these are odd questions, but I can't help but wonder if I could somehow be hurting my LO by continuing to breastfeed. Right now, I'm at the phase of bfing where I really enjoy it, perhaps more than my baby, so am I being selfish continuing to feed him when I'm ill?

Please help me make sense out of BFing now.

[KristyDi]

I don't know much about Lyme's. Do antibiotics knock it out pretty easily? Is it easy to test for? If the answer to both of those is yes, then I'd say have your LO tested, treat if necessary, and continue breastfeeding. If Lyme's is more complex, then obviously there is more to consider.

If it hasn't hurt him yet, then I think it's unlikely to now that you're receiving treatment.

ETA

Is BM made to support baby's health more than the mothers?

I know your body will rob itself of things like calcium in order to make milk so that seems to suggest that it's geared more to the baby.

[CoBabyMaker]

I am so glad that you are getting treatment! I know that getting diagnosed can be a long, frustrating process. (My dad and uncle both have Lyme Disease.) I hope you feel relief from your symptoms soon!
Hope this is somewhat helpful: KellyMom

[Llyra]

I had Lyme the summer of 08. Anyway, I was nursing two toddlers at that point. My Lyme was only in the second stage, and therefore very easy to treat-- I did two weeks of abx and have been just fine ever since. But all that is beside the point-- the point I'm trying to get to is that my kids didn't get it.

If it were me, I don't think I'd worry about it. I did my research then, and what I found was very reassuring. Check out the kellymom link the PP provided.

[CheriK]

Do you have a copy of Hale's? According to the 2008 edition, "Lyme disease is caused by infection w/ the spirochete, borrelia burgdorferi. This spirochete is transferred in-utero to the fetus and is secreted into human milk and can cause infection in breastfed infants." He references two sources for the transfer and infection: a 1995 article from Diagnostic Microbiology of Infectious Diseases, and a 1990 article from Scandanavian Journal of Infectious Diseases. This is different from the Kellymom info, and references older data. I checked his forums and there's no additional/new information posted.

He goes on to say, "If diagnosed postpartum or in a breastfeeding mother, the mother and infant should be treated immediately. In children (>7 years)and adults, preferred therapy is doxycycline (100mg PO twice daily for 14-21 days), or amoxicillin (500mg three times daily for 21 days). In breastfeeding patients, amoxicillin therapy is probably preferred but doxycycline can safely be used. In the infant, use amoxicillin (40mg/kg/day (max 3 grams) with probenecid (25mg/kg/day) divided into three doses/day for a duration of 21 days." He lists several other alternative antibiotics for treatment in adults as well.

Although it sounds like this could transfer through your milk, you're getting treated, right? I know only a little about Lyme disease etiology, but do they expect to cure your infection or only manage it? If the antibiotics are expected to fully resolve the infection, then I don't see why weaning would be advised. Your son's already been exposed. It seems like continuing to breastfeed with appropriate treatment for both you and your son (if necessary - you'll probably want to consult his doctor) would be the best approach.

Breastmilk passes antibodies and antiinflammatory factors through your milk to your infant. So, whatever viruses/bacteria/fungi/etc. that you've been exposed to and your immune system reacts to, your baby will get immune support to fight. So even if you pass an illness to your son through your milk, you're also passing along what he needs to fight that illness. And as he gets older and nurses less, these immune factors actually become concentrated in your milk, so he continues to get the immune support as long as he's nursing.

[Penny4Them]

Thank you ladies. I'm feeling just terrible. I keep waxing and waning emotionally ... one minute I feel good, the next I'm in a sheer panic and dealing with terrible anxiety and worry (totally NOT like me).

I think I had Lyme about 5 yrs ago (not dxed but it all makes sense now) and I think I was bitten again a couple weeks ago. Doc has given me Ceftin for one month and said it's class B abx so compatible with nursing. (Hale's Web site says ok too.)

I don't have Hale's book, but I plan to give that to my baby's doc, as I'm very concerned. I don't believe Lyme was active during my PG as I was super healthy except for elevated BP in last part of PG (not pre-ecl related).

Does anyone know how much ABX my son is getting via my milk? I actually feel like I want him to get as much as possible, to help him in case he has it too.

CheriK, Would it be at all possible for you to send me a link or scan that page with sources for me to share with the doc, and tell me full title of book? I'd be most grateful. The ped and I were discussing whether titre testing would be appropriate for him, but she thought it would be inconclusive as he'd probably have titres from my BM, so it couldn't determine if he has active disease.

[CheriK]

I would be happy to scan the pages for you, but not sure how to get them to you (not that familiar w/ how the forums work). If you know how to do that. . .You might also contact a LLL Leader or IBCLC in your area, as they should have Hale's handy.

The full title is "Medications and Mothers' Milk: Thirteenth Edition" by Thomas W. Hale, PhD, 2008. A new edition (2010) is either just released or due to be released in the next few weeks. YOu can buy off Amazon for about $30; might be worth it (and then could donate to your baby's doctor's office who really should have such references :-)

According to the same book, cefuroxime (Ceftin) is "secreted into human milk in small amounts, but the levels are not available."(ref. 1995 pharmacological info from the drug manufacturer). Most medications are not secreted into milk in large enough quantities to be therapeutic.