Anthrax and Breastfeeding

Overview

It is rare for people in the United States to get anthrax.

Anthrax is a serious disease caused by caused by Bacillus anthracis and other rare Bacillus species that express anthracis toxins.

These bacteria naturally occur in soil and commonly affect domestic and wild grazing animals, such as cattle and deer around the world.

The bacterium forms spores. People get infected with anthrax when spores get into the body, activate, and multiply.

All types of anthrax can eventually spread throughout the body and cause death if they are not treated with antibiotics or antitoxin. You can learn more about anthrax.

Anthrax and breastfeeding

Is it safe for a mother to continue breastfeeding if she has been exposed to anthrax?

Usually. Clinical management of women who give birth while receiving treatment for anthrax does not require mother-infant separation. Because there is no evidence of anthrax transmission through human breast milk, anthrax exposure is not considered harmful for breastfeeding or providing expressed human milk.

Women with active anthrax skin lesions on the breast should cover the sore and not breastfeed from the affected breast until after 48 hours of appropriate antimicrobial drug therapy (antibiotics). B. anthracis has not been isolated from skin lesions 48 hours after initiating appropriate antimicrobial drugs. Therefore, breastfeeding can resume from the affected breast after 48 hours.

Antibiotics

Some antibiotics are safer than others while breastfeeding. Ciprofloxacin is recommended as the first-line antimicrobial agent for post-exposure prophylaxis (PEP) for asymptomatic, lactating women. The American Academy of Pediatrics considers ciprofloxacin and tetracyclines (which include doxycycline) compatible with breastfeeding because infants absorb only a small amount of these drugs.

Physicians may prescribe amoxicillin if the strain of anthrax is susceptible to penicillin and no other contraindications to the mother are present. Amoxicillin is categorized as safe for use with infants. Health care providers should always weigh the risks and benefits when prescribing medications to breastfeeding mothers.

Learn more about antimicrobial considerations for breastfeeding women and safe prescription medication use while breastfeeding.

Anthrax vaccine and breastfeeding

Is the anthrax vaccine safe for breastfeeding mothers and their infants?

Yes. Anthrax vaccines are administered as a component of a PEP regimen or to persons in occupations placing them at risk for exposure. There is no biological reason to suggest that breastfeeding women or breastfed infants have an increased risk for adverse events after vaccination with anthrax vaccine absorbed (AVA) or PEP. Therefore, breastfeeding is neither a precaution nor a contraindication to vaccination in a pre-or post–anthrax event setting.

Learn more

• What is Anthrax?—CDC
• Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women—CDC
• Pediatric Anthrax Clinical Management—American Academy of Pediatrics
• Use of Anthrax Vaccine in the United States: Recommendation of the Advisory Committee on Immunization Practices (ACIP), 2009—CDC