MRSA and breastfeeding

[Tina Lavy]

I have a pregnant mom who had been diagnosed with MRSA with the last pregnancy. Her EDD is April 17th. Her original OB said she should not breastfeed. She will be seeing a new OB. She said she is taking tetracycline. Is she able to breastfeed? If so, what references should I give to her so that she can discuss breastfeeding with her new OB?

Thank you,

Tina Lavy, IBCLC

[admin]

Dear Tina:

The fact that she is a carrier for MRSA has nothing to do with breastfeeding. Approximately 4% of the American population carries this bug, and they do just fine. You stated that she is taking tetracycline. I hope she is not taking this while pregnant (> 3 weeks), as it could easily produce staining of the teeth and potentially bone abnormalities.

If she is NOT taking tetracycline chronically after delivery ( > 3 weeks), then she can breastfeed without problem. If she is taking it permanently, then no, she should not breastfeed.

Tom Hale PH.D.

[Jeanine Dorman]

Dr Hale
If the mother has active MRSA is there a problem with her breastfeeding? There is little noted about MRSA and I understand it can pass through the breastmilk. Thoughts?

[cpride]

Dear Jeanine,

There are several variables that affect breastfeeding with MRSA. First, it depends on where the MRSA infection is located. If it is an extremity or the torso, then as long as mom keeps the area covered and uses good handwashing technique there is little risk to the infant. If the infection is on her breast close to the arreola, it is recommended to pump & discard milk on the affected side until she has been on antibiotics 48 hours, but she may continue to breastfeed on the unaffected side. If she has an abscess that has been drained on her breast, if the surgical wound is close to the arreola, she should not breastfeed on that side until the wound has healed to prevent any drainage or pus from entering the infant's mouth. Second, if she has systemic symptoms such as fever and chills, she should begin her antibiotic regimen and wait 24 to 48 hours after beginning her antibiotic regimen before returning to breastfeeding. Once her systemic symptoms have resolved then she may restart breastfeeding. There is a very good protocol from the Academy of Breastfeeding Medicine on Mastitis that addresses MRSA and breast abscess. The website is www.bfmed.org and go to protocol # 4. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[sharv6]

I have a pregnant mom that has a history of MRSA within the past year, and states she has problems with cracked nipples when she has breastfed her previous babies. We will help her try to prevent the nipple damage this time around, but if they do crack again, is this considered a problem as far as the MRSA is concerned?

[admin-james]

I'm not sure I understand your question, sharv6. Can you rephrase?