Quando os bebês nascem, eles adquirem flora intestinal de seus pais microbiota. A composição desta microbiota é afetada pelo modo de entrega, bem como pela genética, o ambiente, e o modo de alimentação. O ato de amamentar influencia a flora intestinal do lactente por causa da transmissão dos organismos da pele do genitor. Leite materno também contém componentes that allow for the growth of some beneficial microbes while offering protection from harmful ones. Breastmilk also directly influences the development of the infant’s immune system.
While human milk can be a source of normal microflora as well as harmful patógenos, there are very few infectious diseases for which breastfeeding needs to be stopped or interrupted.1 In developed countries, HIV-1, HIV-2, HTLV-I, and HTLV-II are the only infectious diseases that are considered absolute contraindications to breastfeeding.2 3
According to the CDC, someone with these conditions should not breastfeed or feed their expressed milk:4
- If diagnosed with the human immunodeficiency virus (HIV)5
- If infected with human T-cell lymphotropic virus type I or type II6
- If using an illicit street drug, such as PCP (phencyclidine) or cocaine7
- If suspected or confirmed to have Ebola virus disease8
Temporary contraindications to breastfeeding and/or feeding expressed milk are certain medications, diagnostic imaging with radiopharmaceuticals, anyone with active lesões from HSV, Hepatite, Sífilis, Catapora, and Monkey Pox), and Brucellosis.9
When someone is diagnosed with an doença infecciosa, they have already exposed their infant to the pathogen. The interruption or the stopping of breastfeeding does not prevent exposure, and it may instead decrease the infant’s protection that comes through the protective factors found in breastmilk. Portanto, common bacterial, fungal, and viral infections in which someone’s health is not compromised are not contraindications to breastfeeding.
No entanto, while certain infectious diseases are not transmitted through breastmilk, pathogens can be transmitted via handling, by the donor or by the recipient. Someone could have minor lesions and not know that they are a sign of an infectious disease. Someone may be in an open relationship and not know the status of their partner. Regular testing for certain infectious diseases is recommended by milk banks, and it is important to fully divulgar any past or potential present exposure to infectious diseases. Por favor, veja também Casa pasteurização when the donor status is not (fully) known.
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- Noni e MacDonald. 2016. Maternal Infectious Disease and Breastfeeding
for a quick overview of infectious diseases and corresponding breastfeeding management. ↩︎ - Roberto M.. Lourenço. 2020. Transmissão de doenças infecciosas através do leite materno e da amamentação ↩︎
- Ver Vírus da imunodeficiência humana (HIV) Para maiores informações. ↩︎
- Associação de Bancos de Leite Humano da América do Norte. Arquivado. HMBANA|Doe Leite excludes donors who have had a positive blood test result for HIV, HTLV, Hepatite B ou C, ou Sífilis, cujo parceiro sexual está em risco de HIV, que usam drogas ilegais, que fuma ou usa produtos de tabaco, que receberam um transplante de órgão ou tecido ou uma transfusão de sangue na última 12 mês, que regularmente têm mais de duas onças ou mais de álcool por dia, que estão no Reino Unido há mais de 3 meses ou na Europa por mais de 5 anos desde 1980 e que nasceram ou viajaram para Camarões, República da África Central, Chade, Congo, Guiné Equatorial, Gabão, Níger, ou Nigéria. ↩︎
- CDC - Vírus da imunodeficiência humana (HIV) Observação: recommendations about breastfeeding and HIV may be different in other countries. ↩︎
- AAP 2012. Amamentação e o uso de leite humano ↩︎
- Exception: Narcotic-dependent mothers who are enrolled in a supervised methadone program and have a negative screening for HIV infection and other illicit drugs can breastfeed. ↩︎
- CDC - Doença do vírus Ebola ↩︎
- CDC - Contra-indicações para amamentar ou dar leite materno ordenhado para bebês ↩︎
