Literature review for - Flourish Paediatrics

Syphillis in Breastfeeding Mothers
Search results
The initial search of the databases included 17 references on maternal syphilis during
breastfeeding. The detailed search is included in a separate document on searches. Data were
extracted from one narrative review but the evidence was insufficient to develop a body of
evidence statement.
Notes on maternal syphilis during breastfeeding
A review by Cook reported that treponemes (the causative agents of syphilis) are not present
in human milk and breastfeeding is not a mode of transmission of maternal syphilis.
Infections of the skin or breast tissue (eg chancres) or cracked, bleeding nipples could be a
means of transmission so in these cases breastmilk expression is recommended. Cook used
case-reports to develop the statements on syphilis in breastfeeding women (Cook 1995).
Notes on the prevalence of ectoparasites, gonorrhoea and epstein barr virus (EBV) in
breastfeeding women
The review by Cook also included information on other STDs:
Ectoparasites are spread predominantly by close contact. As breastfeeding is an intimate
physical event these potential STDs could be transmitted through its close contact.
Gonorrhoea. Nothing was found in the literature with respect to studies of gonococcal spread
via breastmilk. However possible risk of drug therapy of this on the breastfed infant
Epstein barr virus (EBV) is a herpes virus. EBV has been demonstrated in breastmilk,
however the implications of this are unknown. (Cook 1995)
Syphilis in Australia
In Australia there were 2835 cases of syphilis notified in 2009. Recent increases have been
in the gay male sector of the population. An effective screening and treatment program for
pregnant women for syphilis in Australia means that is unlikely that Syphilis will be an issue
for breastfeeding (Australian Institute of Health and Welfare 2010).
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