Syphilis is a serious infection caused by the bacterium Treponema pallidum. If left untreated, it can lead to severe health complications affecting the heart, brain, and other organs. This information provides clear guidance regarding the safety of feeding an infant when a parent has a syphilis diagnosis. Understanding the mechanisms of transmission is important for informed decisions about infant health.
Syphilis Transmission Through Breast Milk
The Treponema pallidum bacterium is generally not transmitted to an infant through the breast milk itself. Medical consensus indicates that consuming milk from a parent who has syphilis does not inherently pose a risk to the baby.
The safety concern arises from direct contact with active syphilitic lesions. In the primary or secondary stages, painless sores, called chancres, can appear on the breast, nipple, or areola. Transmission occurs if the infant’s mouth or skin directly touches one of these open lesions during feeding.
If a chancre is present on a breast, feeding from that specific breast must be temporarily avoided to prevent contact transmission. The parent can safely pump or hand-express milk from the affected breast to maintain their milk supply and prevent engorgement. This expressed milk is safe for the baby to consume, provided the pumping equipment did not touch the lesion during collection. Once the lesion has completely healed, direct feeding can resume on that side.
Primary Syphilis Transmission Routes to Infants
The most significant pathway for infant infection is congenital syphilis, where the infection passes from the pregnant person to the developing fetus. This transmission occurs in utero, across the placenta, at any point during the pregnancy.
The likelihood of transplacental transmission is highest when the parent has an early-stage infection, such as primary or secondary syphilis. Without adequate treatment, the bacteria can cause the fetus to be born prematurely or result in severe health issues for the newborn. Transmission can also happen during the birthing process itself if the infant’s skin or mucous membranes touch infectious lesions in the birth canal or on other parts of the body.
Treatment Protocols and Breastfeeding Safety
Universal prenatal screening is a standard public health measure intended to identify syphilis infection early in pregnancy. This screening allows for timely intervention to prevent the serious outcomes associated with congenital syphilis, as the infection is highly treatable with antibiotics.
The standard treatment for syphilis in pregnant and lactating individuals is Penicillin G, which is highly effective against Treponema pallidum. Penicillin is the only medication proven to successfully cross the placenta in sufficient concentration to treat the infected fetus in utero. Once the parent begins the appropriate treatment course, the infectiousness of the bacteria drops rapidly, often within 24 hours.
The decision to breastfeed while undergoing treatment is generally considered safe and encouraged by medical professionals. Penicillin G is compatible with breastfeeding and does not require the parent to stop feeding the baby. The primary instruction remains to avoid direct contact with any active sores until they have completely healed.
After birth, all infants born to parents who tested positive for syphilis require a thorough evaluation by a pediatrician, even if the parent received treatment. This evaluation includes blood tests to check for signs of infection. Depending on the parent’s treatment history and the baby’s test results, the infant may need follow-up care or a course of antibiotics. Attending all recommended follow-up appointments is important to ensure the infant does not develop any delayed symptoms of the infection.