oh, baby?

September 11, 2008 6:05 PM

From a safer sex standpoint, how risky is playing with breast milk?

It is a bodily fluid, but I can't seem to find much information about it in this context. I know that HIV is transmissible through breast milk, but are there other sexually transmitted (or other) diseases that can be carried through that medium, or other risks that it would be important to know about?

posted by streetdreams to Health & Fitness (3 answers total)

The Centers for Disease Control recommend that moms not breastfeed in the following
conditions:

Has been infected with the human immunodeficiency virus (HIV)

Is taking antiretroviral medications

Has untreated, active tuberculosis

Is infected with human T-cell lymphotropic virus type I or type II

Is using or is dependent upon an illicit drug

Is taking prescribed cancer chemotherapy agents, such as antimetabolites that interfere with DNA replication and cell division

Is undergoing radiation therapies; however, such nuclear medicine therapies require only a temporary interruption in breastfeeding


(http://www.cdc.gov/breastfeeding/disease/contraindicators.htm)


The American Academy of Pediatrics says only active, untreated TB and HIV. (For infectious disease)

(http://aappolicy.aappublications.org/cgi/content/full/pediatrics;100/6/1035)

And keep in mind, these are in the context of moms and babies. (Perhaps the baby's saliva and/or gut play a role in killing any infectious agent in "infected" milk? I don't know.)


I'd still be worried about hepatitis B, even though it's not called out in the mom/baby context.
posted by FergieBelle at 6:47 PM on September 11, 2008

Breast milk is a bodily fluid with live components. Universal precautions absolutely apply, though the overall risk of infecting a sex partner with breast milk from a lactating woman with transmittable disease is thought (different from proven) to be much smaller than blood to blood transmission (because of relatively low viral loads in breast milk and the fact it contains anti-viral and anti-bacterial components, as well as antibodies meant to temporarily inoculate the infant against diseases the mother has been exposed to) . However, there are no appreciable studies that really prove that this kind of play is safer, and so breast milk play needs to be safe play--in this case, the simplest way is for both partners to be tested.

And no, your saliva and tummy juices won't necessarily "kill" anything you're being exposed to--plus, I'm guessing more than just adult breastfeeding is going on--you're introducing, in this kind of play, a not insignificant volume of body fluid that has an opportunity to enter the partner's body in a variety of ways.

And as a postscript, infants have a low transmission rate of HIV from their positive mothers only when they are exclusively breast fed (no formula or other foods). It's not known exactly why, but one theory I've been presented hypothesizes that formula and other foods have the risk of irritating the infant's gut, thereby providing a route for the virus to infect the infant (basically a open, micro-wound in the gut).

Be safe, apply universal precautions, breast milk play introduces risk, and get tested. I am a lactation educator working on clinical hours to take my boards to be an IBCLC, but obviously, my primary focus is mother/infant pairs. I am not your health care provider.
posted by rumposinc at 11:11 PM on September 11, 2008

Breast milk is one of the four bodily fluids that have enough live virus (in an HIV+ individual) to transmit the HIV virus to a partner. The other three are blood, seminal fluid, and vaginal secretions. You should treat breast milk in the same way you would one of these three bodily fluids fluids.
posted by hworth at 6:23 AM on September 12, 2008