Last update July 16, 2023

Maternal Toxoplasmosis

Compatible

Safe substance and/or breastfeeding is the best option.

Toxoplasmosis is one of the most widespread infections in the world, with a prevalence of 11-25% depending on the country (Red Book 2021-24, Abarca 1997). It is caused by the Toxoplasma gondii parasite which is hosted in cats. The infected animal, through its droppings, contaminates water, fruits and vegetables and infects other animals and people.

Human infection occurs due to contact with infected cats, the consumption of unwashed fruits and vegetables, contaminated goat’s milk and the consumption of undercooked meats, among others.

The infection usually presents with mild symptoms even in infants, except in immuno-compromised persons and in the case of congenital infection during pregnancy, which is very serious.  


Toxoplasmosis is not transmitted through breast milk. (CDC 2021)

The parasite is transmitted through the milk of various animals (Chiari 1984), but transmission through breast milk has not been documented (CDC 2021, Lawrence 2016 p465, Capobiango 2015), although it has been suggested in a few cases (some very old) as a probability. (Brasil 2006, Bonametti 1997, Langer 1963)

Given the absence of evidence of its transmission through milk, the benignity of postnatal infection and the presence of antibodies against Toxoplasma in breastmilk, there is no reason to contraindicate breastfeeding in mothers who have suffered from toxoplasmosis in the past, during pregnancy or at the time of breastfeeding. (CDC 2021, Lawrence 2016 p 225, 466 and 789, Bonametti 1997)

The medication for the treatment of toxoplasmosis is usually compatible with breastfeeding (Lawrence 2016 p789).


See below the information of these related products:

  • Atovaquone (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Clindamycin (Safe substance and/or breastfeeding is the best option.)
  • Dapsone (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Pyrimethamine (Safe substance and/or breastfeeding is the best option.)
  • Spiramycin (Safe substance and/or breastfeeding is the best option.)
  • Sulfadiazine; Sulphadiazine (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Trimethoprim-Sulfamethoxazole (TMP-SMX; TMP-SMZ) (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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References

  1. (Red Book). AAP. Kimberlin DW, Barnett ED, , Lynfield R, Sawyer MH eds. Red Book: 2021-2024. Report of the Committee on Infectious Diseases. 32th ed. Elk Grove Village, - 2021
  2. CDC. Centres for Disease Control and Prevention. Toxoplasmosis and Breastfeeding. Breastfeeding and Special Circumstances. 2021 Full text (link to original source) Full text (in our servers)
  3. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  4. Capobiango JD, Mitsuka-Breganó R, Monica TC, Ferreira FP, Reiche EM. ACUTE TOXOPLASMOSIS IN A BREASTFED INFANT WITH POSSIBLE TRANSMISSION BY WATER. Rev Inst Med Trop Sao Paulo. 2015 Dec;57(6):523-6. Abstract Full text (link to original source)
  5. Capobiango JD, Mitsuka-Breganó R, Monica TC, Ferreira FP, Reiche EM. Acute toxoplasmosis in a breastfed infant with possible transmission by water Rev Inst Med Trop Sao Paulo. 2015 Abstract Full text (link to original source) Full text (in our servers)
  6. Brasil. Secretaria de Vigilância em Saúde. Surto intra familiar de toxoplasmose, Santa Vitoria do Palmar-RS, julho de 2005. Bol Eletrôn Epidemiol. 2006;6(3):1-7. 2006 Full text (link to original source) Full text (in our servers)
  7. Abarca K, Vial PA, Zamorano J, Paris C, Ferrés M, Villarroel L, Ferreccio C. [Seroprevalence of cytomegalovirus and Toxoplasma gondii in healthy subjects under 30 years old in Santiago, Chile]. Rev Med Chil. 1997 May;125(5):531-8. Spanish. Abstract
  8. Bonametti AM, Passos JN, Koga da Silva EM, Macedo ZS. Probable transmission of acute toxoplasmosis through breast feeding. J Trop Pediatr. 1997 Abstract Full text (link to original source)
  9. Chiari Cde A, Neves DP. [Human toxoplasmosis acquired by ingestion of goat's milk]. Mem Inst Oswaldo Cruz. 1984 Jul-Sep;79(3):337-40. Portuguese. Abstract Full text (link to original source)
  10. Langer H. Repeated congenital infection with toxoplasma gondii. Obstet Gynecol. 1963 Abstract

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