Sting / Bite of Arthropods

Given the absence of problems or low risk for the infant when a mother has been bitten by mosquitoes, wasps, bees, spiders or other insects, interruption of breastfeeding is not recommended. Only in case of widespread reaction in the mother or infants under one month of life, it may be prudent to wait for about 3 hours to resume breastfeeding.

The insect venom is a complex mixture of polypeptides, amines, proteinaceous enzymes (proteases, phospholipases, hyaluronidase), histamine and other substances ^{(Wu 2022, Furtado 2020, Tanuwidjaja 2012, Pucca 2019, Laustsen, 2016)}. Most of these substances cannot pass into breast milk because of their high molecular weight. Some that would pass into the milk do it in very small amounts, yet due to its proteinaceous nature it is readily inactivated in the gastrointestinal tract of the infant and not absorbed, except in premature babies and during the immediate neonatal period, which may show an increased permeability of the intestine.

It has been reported a mild allergic-like reaction in a 12-days-old newborn who was breastfed one hour after the mother had been chopped on the lip by a bee that caused to her a widespread reaction in the face. ^{(Kaya 2012)}

Despite hundreds of thousands of scorpion stings recorded in humans each year, no adverse effects have been reported in infants of mothers who have been stung. ^{(Dorce 2017)} 

Topical or systemic products that can be used to treat insect bites (like repellents, antihistamines, epinephrine, corticosteroids, nonsteroidal antiinflammatory, antibiotics, etc.) are compatible with breastfeeding. Whenever necessary, it should be used 2nd generation antihistamine (e.g. Loratadine, Cetirizine) due to a lacking sedative effect.

The antivenoms or antivenin sera ^{(Laustsen, 2016)}, that can be applied in certain severe cases, are specific immunoglobulins obtained from serum of horses or other animals that due to their high molecular weight do not pass to milk.

An anecdotal fact is that bee venom, and specifically some of its peptides such as melittin and others, has been used to increase milk production in various livestock farms and to prevent bovine mastitis. ^{(Orozco 2024, Choi 2001, Grandison 1984)}

The bite of some insects, especially mosquitoes, can transmit infectious diseases (Zika virus transmitted by Aedes mosquitoes, Ae. Aegypti and Ae. Albopictus mosquito or Tigre, West Nile fever, Malaria, etc.) or bugs in case of Chagas’ Disease. However, these diseases are not transmitted through the milk to the infant. Covid-19 is not transmitted by insect bites. ^{(WHO/OMS 2020)}

See below the information of these related products:

• Adrenaline (Safe product and/or breastfeeding is the best option.)
• Cetirizine Hydrochloride (Safe product and/or breastfeeding is the best option.)
• Chagas Disease (Safe product and/or breastfeeding is the best option.)
• Loratadine (Safe product and/or breastfeeding is the best option.)
• Maternal West Nile Fever (WNF) (Safe product and/or breastfeeding is the best option.)
• Zika (flavivirus), Maternal Zika Virus Infection (Safe product and/or breastfeeding is the best option.)