Breastfeeding in Mothers Who are Carriers of Staphylococcus Aureus (2023)

A recent study explored the relationship between maternal colonization (bacteria on the mother’s skin surface) with Methicillin Sensitive Staphylococcus Aureus (MSSA), during pregnancy and delivery to determine the association with infant colonization.[1] Staphylococcus aureus is one of the most common causes of community and hospital acquired sepsis (a serious bacterial infection in the blood).[2]Therefore, recognizing a patient’s colonization with MSSA and the antibiotic resistant form of this bacteria, Methicillin Resistant Staphylococcus Aureus (MRSA) is important, especially in vulnerable populations such as those babies admitted to the neonatal intensive care unit (NICU).[2] About 30% of Americans are colonized with MSSA and 1-4% of mothers and infants are colonized with MRSA.[1] Although some of the risk factors for colonization with MSSA are known such as number of household members, breastfeeding, antibiotic exposure, the risk of vertical transmission (passing the bacteria to the infant during delivery because of maternal vaginal colonization) is unknown.

A previous publication from 2003, studied the pattern of MSSA carriage in the first 6 months of life.[2] In this study the authors determined if infants had a similar pattern for colonization as adults and studied the roles of the individual, environment and bacteria on colonization. There appear to be three general patterns of colonization in adults; 20% persistent non-carriers, 20% persistent carriers and 60% intermittent carriers. This study found maternal colonization rates with MSSA to be about 30% and infant colonization rates to be 40 to 50% in the first 8 weeks of life. There was a significant reduction in infant colonization of the nose (21%) by 6 months of age. It was determined that 25% of infants were never colonized with the MSSA and the remaining infants had a different pattern of colonization than adults. It was also noted that about 68% of the mother-infant pairs were colonized with the same strain of MSSA. Exposure to siblings was found to be a possible factor for increasing infant colonization but did not reach significance. The environmental factors found to be significant were breastfeeding and maternal colonization at any time during the 6 months. The association with breastfeeding was not influenced by maternal colonization or the age of the infant (breastfeeding and infant colonization decreased over time). The authors hypothesized that the reason why breastfed infants had a greater chance of colonization may have been from MSSA colonization of the nipples, which may be supported by the fact that breast infections during lactation are typically caused by MSSA.

(Video) Quick Tips on Breastfeeding

The most recently published article reviewing the risk of vertical transmission enrolled 629 mother-infant pairs between June 2007 and March 2009, at two centers in the US (Vanderbilt & Memphis).[1] Women were eligible to participate in this prospective study if they were 34 to 36 weeks of gestation. Questionnaires were used to determine risk factors for colonization and swabs of the mother (nasal and vaginal) and infant (nasal and umbilical) were taken to test for MSSA and MRSA during the first 4 months of life.

The factors found to be statistically significant for increasing the risk of infant colonization with MSSA at birth were race and mode of delivery. African American infants (75% vs 41%) and those born vaginally (86% vs 69%) had the highest risk.[1] In determining the association between maternal and infant colonization, this study found the odds of an infant being colonized was significantly higher if the mother was colonized herself. This study had 20 maternal-infant pairs in which the mother was colonized during pregnancy and the infant was colonized within 2 hours of birth, 8 of them had nasal colonization (3 of which were MRSA) and 12 had vaginal colonization (3 of which were MRSA). Of the 20 pairs only two of the infant isolates suggested vertical transmission, as the bacterial strains were exactly the same in the mother. Of the women colonized at delivery, 20 had infants that were colonized at birth and 14 at discharge; colonization peaked at 2 months of age (51 maternal-infant pairs) and declined to 9.3% by 4 months of age (of which 43% were MRSA). This decline in colonization with increasing infant age was also see in the previous study discussed above. [2]

Although this study suggests that breastfeeding is a risk factor for colonization the number of women breastfeeding was not reported; therefore, the effect on colonization is unknown in this set of mother-infant pairs.[1] This study did find a higher rate of colonization with MSSA and MRSA compared to other previously studied populations (10% vs. 2-5% of mothers and 2.5% vs. 1% of infants at delivery carried MRSA). About one third of the MRSA isolated in this trial was the USA300 clone. Horizontal transmission (contact with mother and family members) was the most common mode of colonization of mother-infant pairs in this study and although vertical transmission increased the likelihood of early neonatal colonization (within 2 hours of birth), vertical transmission only occurred in two infants. Even though this study found higher rates of MSSA and MRSA carriage only two infants had clinical infections, which suggests that while infants are colonized with the bacteria the risk of infection is low.

(Video) Breastfeeding your baby with the Thompson Method | Parent Education | Mater Mothers

In another study that looked at perinatal transmission, the authors found that of 304 women, 43 were colonized with MSSA (vaginal, nasal or both), 9 had MRSA.[3] Of the 252 infants, 25 were colonized with MSSA (skin, nasal or both) at delivery and/or discharge, 9 had MRSA. Of the mother-infant pairs colonized with bacteria only five were found to have the same strain of MSSA. Five infants from this study developed staphylococcal infections within the first month of life, 3 with small pustule like skin infections, 1 with periorbital cellulitis and 1 with mastitis. Of the five infants with an infection, only one had been colonized in the perinatal period; these infections were from colonization beyond 48 hours of life.

Kawada et al reviewed breast milk and skin samples from eight mothers without mastitis, along with oral cavity and nasal cultures from their infants who were younger than three months of age.[4] There rate of staphylococcus aureus transmission between these mother-infant pairs was 50%, 4 pairs and 1 infant were colonized. Two of the four pairs were found to have MRSA.

Behari et al reported a case of MRSA colonization and infection in pre-term triplets. Routine surveillance cultures, taken due to a recent outbreak of MRSA in the NICU, revealed MRSA colonization starting on day of life 10 for infant A and 18 for infant B. [5] Infant C who was not given breast milk had negative routine cultures and passed away on day of life 15 from premature lung disease. Infant A developed MRSA sepsis on day of life 14, an MRSA eye infection on day of life 18 and a pneumonia from multiple bacteria on day of life 47. Infant B developed a coagulase-negative staphylococcus bacteremia on day of life 6 and was found to have an MRSA eye infection on day of life 70. Breast milk stored prior to colonization of infants A & B was tested on day of life 33 and the cultures grew the same strain of MRSA. This mother had no signs or symptoms of mastitis or other infections due to MRSA.

(Video) Breastfeeding: correct attachment

The trials reviewed supported the findings, that horizontal transmission (maternal and family contact) was one of the greatest risk factors for infant nasal colonization and that direct vertical transmission was less common.[1-5] However, the timing of colonization and infection varied in all five of these studies. The evidence for an increased risk of serious infection from infant colonization with MSSA needs to be replicated with a larger prospective study. At this time it is not clear if interruption of breastfeeding or changes in maternal-infant contact are beneficial for mothers who are colonized with MSSA or MRSA. Future studies focusing on the clinical significance of swabbing mothers to determine maternal colonization, identifying risk factors for infection of infants with colonized mothers & family and interventions such as changes in maternal-infant contact, breastfeeding or recommending decolonization need to be determined before changes in practice can be recommended.[1-5]

In summary, it appears that colonization from mother to child due to close contact may be as prevalent as transmission via the mother’s milk. Thus, until more is known about the transmission of MSSA and MRSA, there is no substantive reason to withhold breastmilk from mothers who are carriers of MSSA or MRSA.

Hilary Rowe BSc(Pharm), PharmD, ACPR., Cynthia Pride RN., Thomas W. Hale, R.Ph.,Ph.D.

(Video) Why aren't French mothers breastfeeding? | DW News

InfantRisk Center


  1. Jimenez-Truque N, Tedeschi S, Saye EJ et al. Relationship between maternal and neonatal staphylococcus aureus colonization. Pediatrics 2012;129(5): 1-8.
  2. Peacock SJ, Justice A, Griffiths D et al. Determinants of acquisition and carriage of staphylococcus aureus in infancy. J Clin Microbiol 2003;41(12):5718-25.
  3. Pinter DM, Mandel J, Hulten KG, Minkoff H, Tosi MF. Maternal-infant perinatal transmission of methicillin-resistant and methicillin-sensitive Staphylococcus aureus. Am J Perinatol. 2009 Feb;26(2):145-51.
  4. Kawada M, Okuzumi K, Hitomi S, Sugishita C. Transmission of Staphylococcus aureus between healthy, lactating mothers and their infants by breastfeeding. J Hum Lact. 2003 Nov;19(4):411-7.
  5. Behari P, Englund J, Alcasid G, Garcia-Houchins S, Weber SG. Transmission of methicillin-resistant Staphylococcus aureus to preterm infants through breast milk. Infect Control Hosp Epidemiol. 2004 Sep;25(9):778-80.


Can you breastfeed with Staphylococcus aureus? ›

In most cases, mothers with a staph or MRSA infection can continue to breastfeed their infant.

What precautions should be taken by a nurse who is a staph carrier? ›

Health care workers and other hospital staff can prevent staph infection by: Washing their hands before and after they touch every patient. Wearing gloves and other protective clothing when they treat wounds, touch IVs and catheters, and when they handle bodily fluids. Using the proper sterile techniques.

What is Staphylococcus aureus carrier? ›

What is staphylococcal carriage? Staphylococcal carriage (or colonization) refers to the asymptomatic carriage of Staphylococcus aureus on a person's skin or mucous membranes.

Can Staphylococcus aureus prevent a woman from getting pregnant? ›

More evidence is currently emerging to show that Staphylococcus, particularly Staphylococcus aureus, can colonize the reproductive systems and affect their structure and function. Staphylococcal infection has become one of the most common causes of infertility in both males and females.

Can I breastfeed if I have a bacterial infection? ›

Breastfeeding can continue on the affected breast (even if a drain is present in the case of an abscess) as long as the infant's mouth does not come in contact with purulent drainage or open infected tissue.

Is it safe to breastfeed with infection? ›

If you have a cold or flu, fever, diarrhoea and vomiting, or mastitis, keep breastfeeding as normal. Your baby won't catch the illness through your breast milk – in fact, it will contain antibodies to reduce her risk of getting the same bug. “Not only is it safe, breastfeeding while sick is a good idea.

What must nurses do to prevent the spread of infection? ›

Proper use of personal protective equipment (e.g., gloves, masks, gowns), aseptic technique, hand hygiene, and environmental infection control measures are primary methods to protect the patient from transmission of microorganisms from another patient and from the health care worker.

How can you prevent the spread of Staphylococcus aureus? ›

  1. Wash your hands. Thorough hand washing is your best defense against germs. ...
  2. Keep wounds covered. Keep cuts and scrapes clean and covered with sterile, dry bandages until they heal. ...
  3. Reduce tampon risks. ...
  4. Keep personal items personal. ...
  5. Wash clothing and bedding. ...
  6. Take food safety precautions.
25 May 2022

How is staph carrier treated? ›

In patients who are nasal carriers, intranasal mupirocin effectively eradicates intranasal Staphylococcus aureus with a 90% success rate at 1 week (SOR: A, meta-analysis). The addition of bleach baths to nasal mupirocin promotes longer term eradication in patients with colonization beyond the nose (SOR: B, RCT).

How do I know if I have Staphylococcus aureus carrier? ›

Staph screening is a test to find out if you're a staph carrier. Staphylococcus aureus (staph) is a type of bacteria that can cause infections. A carrier is a person who has the bacteria on his or her skin but who isn't sick. The test is done by swabbing the inside of your nose.

What are the main carriers of Staphylococcus? ›

Staphylococcus aureus is a common human commensal but carriage varies between e.g. geographic location, age, gender, ethnicity and body niche. The nares, throat and perineum are the most prevalent sites for carriage in the general adult population.

Can a staph carrier be cured? ›

Is there a treatment for MRSA? People who are carriers of MRSA typically do not require any treatment. In some cases, a healthcare provider may decide to treat someone to reduce the amount of staph on their skin or in their nose. This may prevent the spread of MRSA to others.

What causes Staphylococcus aureus in woman? ›

S. aureus is most often spread to others by contaminated hands. The skin and mucous membranes are usually an effective barrier against infection. However, if these barriers are breached (e.g., skin damage due to trauma or mucosal damage due to viral infection) S.

Can Staphylococcus aureus be cured permanently? ›

Most of the time, minor staph infections can be successfully eliminated. But serious cases may require powerful medicines. Treatment options for an infection caused by staphylococcus bacteria depend on the type of infection you have, how severe it is, and where it's located on or in your body.

What happens if you have Staphylococcus aureus? ›

While these germs don't always cause harm, they can make you sick under the right circumstances. S. aureus is the leading cause of skin and soft tissue infections, such as abscesses, boils, furuncles, and cellulitis (red, swollen, painful, warm skin).

Which antibiotics are safe during breastfeeding? ›

Penicillins, aminopenicillins, clavulanic acid, cephalosporins, macrolides and metronidazole at dosages at the low end of the recommended dosage range are considered appropriate for use for lactating women.

Can I breastfeed while taking antibiotics? ›

In most cases, antibiotics are safe for breastfeeding parents and their babies. “Antibiotics are one of the most common medications mothers are prescribed, and all pass in some degree into milk,” explains the Academy of American Pediatrics (AAP).

What antibiotics are not safe while breastfeeding? ›

Tetracyclines must be avoided during lactation due to possible risks of dental staining and adverse effects on bone development. Metronidazole in a single, high dose is not advised for lactating women, though conventional doses may be used with caution.

How do you treat an infection while breastfeeding? ›

Mastitis treatment might involve:
  1. Antibiotics. If you have an infection, a 10-day course of antibiotics is usually needed. ...
  2. Pain relievers. Your doctor may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
13 Sept 2022

What infections can be transmitted through breast milk? ›

The main hazards of breast-feeding are exposure to the maternal viral pathogens HIV and human T-cell lymphotropic virus-1 (HTLV-1).

What bacteria can grow in breast milk? ›

Human milk contains a wide spectrum of bacteria such as Staphylococci, Streptococci, Corynebacteria, lactic acid bacteria, Propionibacteria, and Bifidobacteria [28]. Among these populations, probiotic bacteria are present in an amount of 101–107 colony forming units per mL [29].

What should the nurse do first to prevent patient infections? ›

  1. Hand Hygiene. Hand hygiene is the most important measure to prevent the spread of infections among patients and DHCP. ...
  2. Respiratory Hygiene/Cough Etiquette. ...
  3. Sharps Safety. ...
  4. Safe Injection Practices. ...
  5. Sterilization and Disinfection of Patient-Care Items and Devices.

What is the most important way in which the nurse can reduce the risk for infection in a patient with a Cvad that has a gauze dressing? ›

CORRECT. A gauze dressing on a CVAD should be changed every 48 hours and as needed. Doing so will reduce the patient's risk for infection.

What are the 3 most important actions to prevent infection? ›

Ways you can reduce or slow the spread of infections include: Get the appropriate vaccine. Wash your hands frequently. Practice physical distancing from members outside your household, when appropriate (staying more than 2 metres (6 feet) apart).

What is the main cause of Staphylococcus aureus? ›

These bacteria are spread by having direct contact with an infected person, by using a contaminated object, or by inhaling infected droplets dispersed by sneezing or coughing. Skin infections are common, but the bacteria can spread through the bloodstream and infect distant organs.

What are the symptoms of Staphylococcus in a woman? ›

You might think you have some kind of bite or ingrown hair. Signs and symptoms of staph infection on your skin include: Abscesses and boils: These painful sores form under your skin, causing redness and pain. Cellulitis: This type of infection causes swollen, red, painful skin and tissue just under your skin.

What is the main source of Staphylococcus aureus? ›

Staphylococcus aureus is a bacterium that causes staphylococcal food poisoning, a form of gastroenteritis with rapid onset of symptoms. S. aureus is commonly found in the environment (soil, water and air) and is also found in the nose and on the skin of humans. S.

Can you be a carrier of Staphylococcus aureus? ›

MRSA is a bacterium (Staphylococcus aureus) which is resistant to treatment with the usual antibiotics. The bacterium can be carried on the skin or in the nose without the person show- ing any signs of infection. This is called being a MRSA carrier.

How common is it to be a staph carrier? ›

Approximately 1 in 3 Americans are carriers of staph bacteria at any time. Up to half of these could be MRSA. It's important to emphasize that Staph aureus or MRSA carriage is not a disease.

Are staph carriers contagious? ›

Staph infections are contagious through person-to-person contact. If an individual with staph has a wound that oozes, someone who comes into contact with this liquid can contract the infection.

What percentage of people are carriers of Staphylococcus aureus without symptoms? ›

Studies show that about one in three (33%) people carry S. aureus bacteria in their nose, usually without any illness. About two in every 100 people carry MRSA.

What are the early symptoms of Staphylococcus aureus? ›

Here are the telltale signs of a staph infection you should know how to recognize.
  • Skin boils or pustules. Wendy Townrow//Getty Images. ...
  • Skin infections. ...
  • Food poisoning. ...
  • Fever and low blood pressure. ...
  • Toxic shock syndrome. ...
  • Sepsis.
4 Sept 2019

How is Staphylococcus aureus transmitted? ›

Transmission: Staph is usually spread through direct contact with a person who has a skin infection or is carrying the bacteria on their skin or in their nose. This can occur in the community by close skin to skin contact, sharing items such as towels or clothes, or touching surfaces that someone else has touched.

Who is most at risk for Staphylococcus aureus? ›

Anyone can develop a staph infection, although certain groups of people are at greater risk, including people with chronic conditions such as diabetes, cancer, vascular disease, eczema, lung disease, and people who inject drugs.

Where do you normally find Staphylococcus aureus in an asymptomatic carrier? ›

Approximately 30% of the population permanently carry S. aureus asymptomatically in their nasal cavity. The risk of infection and transmission to food items or the environment is higher in individuals that are nasally colonized.

Where is Staphylococcus aureus found in the body? ›

Staphylococcus aureus, or S. aureus, is a common bacterium that lives on the skin or in the nose. It is also called golden staph.

Which medicine can cure Staphylococcus aureus? ›

Antibiotics commonly prescribed to treat staph infections include cefazolin, nafcillin, oxacillin, vancomycin, daptomycin and linezolid. For serious staph infections, vancomycin may be required.

What food kills Staphylococcus aureus? ›

Ginger compounds have exhibited the ability to inhibit the growth and even kill oral pathogens. In one study that investigated the effects of ginger and antibiotics on the bacteria Staphylococcus aureus and S.
4 Easy to Find Foods That Fights Staph,UTI and STDs
  • Garlic. ...
  • Pure Raw Honey. ...
  • Coconut Oil. ...
  • Ginger.
18 Jul 2018

Is everyone a staph carrier? ›

A third of Americans carry Staphylococcus aureus, or staph, on their skin or in nasal passages. About 1% of those people, or more than 3 million people, carry MRSA, the staph strain that is hard to treat and resistant to many antibiotics.

What is the common name for Staphylococcus aureus? ›

Different varieties of Staphylococcus aureus bacteria, commonly called "staph," exist. Staph bacteria are normally found on the skin or in the nose of about one-third of the population.

How long does Staphylococcus aureus last in the body? ›

How long it takes for a staph skin infection to heal depends on the type of infection and whether it's treated. A boil, for example, may take 10 to 20 days to heal without treatment, but treatment may speed up the healing process. Most styes go away on their own within several days.

How long does it take to treat Staphylococcus aureus? ›

Practice guidelines recommend at least 14 days of antibiotic therapy for uncomplicated Staphylococcus aureus bacteremia (SAB).

How long can Staphylococcus aureus live? ›

Methicillin-resistant Staphylococcus aureus (MRSA) can survive on some surfaces, like towels, razors, furniture, and athletic equipment for hours, days, or even weeks. It can spread to people who touch a contaminated surface, and MRSA can cause infections if it gets into a cut, scrape, or open wound.

How do I stop being a staph carrier? ›

Follow these steps to avoid a staph infection and prevent it from spreading.
  1. Keep your hands clean by washing them thoroughly with soap and water. ...
  2. Keep cuts and scrapes clean and covered with bandages until they heal.
  3. Avoid contact with other people's wounds or bandages.
17 Apr 2021

Can you live with Staphylococcus aureus? ›

Staphylococci or “staph” bacteria commonly live on the skin and in the nose. Usually, staph bacteria don't cause any harm.

How do you recover from Staphylococcus aureus? ›

Most people recover from staphylococcal infections. Antibiotics typically kill the bacteria shortly after treatment begins. But reinfection and the need for additional treatment sometimes occur. If a staph infection returns, doctors at NYU Langone may prescribe additional medication to treat your symptoms.

Can my baby get staph infection from me? ›

It is possible that a Staph infection could spread to a nursing child during breastfeeding from direct skin contact. If you have a Staph skin infection, it is important to keep the wound covered with bandages so that the baby does not touch the wound or any discharge from it.

What infections can you not breastfeed with? ›

  • Birth Defects.
  • Breast Surgery.
  • Coronavirus Disease (COVID-19)
  • Ebola Virus Disease.
  • Food-borne and Waterborne Illness.
  • Hepatitis B or C Infections.
  • Herpes Simplex Virus (HSV)
  • HIV.

How do you get staph infection in breast? ›

Breast infections are usually caused by common bacteria (Staphylococcus aureus) found on normal skin. The bacteria enter through a break or crack in the skin, usually on the nipple. The infection takes place in the fatty tissue of the breast and causes swelling. This swelling pushes on the milk ducts.

Can Staphylococcus aureus be transmitted? ›

Transmission. S. aureus is most often spread to others by contaminated hands. The skin and mucous membranes are usually an effective barrier against infection.

What are the symptoms of Staphylococcus aureus in a woman? ›

You might think you have some kind of bite or ingrown hair. Signs and symptoms of staph infection on your skin include: Abscesses and boils: These painful sores form under your skin, causing redness and pain. Cellulitis: This type of infection causes swollen, red, painful skin and tissue just under your skin.

How long does a staph infection last in babies? ›

How long it takes for a staph skin infection to heal depends on the type of infection and whether it's treated. A boil, for example, may take 10 to 20 days to heal without treatment, but treatment may speed up the healing process. Most styes go away on their own within several days.

When should a mother avoid breastfeeding and what are the contraindications? ›

The only true contraindications to breastfeeding are the following: infants with classic galactosemia (galactose 1-phosphate uridyltransferase deficiency) mothers, in the US, who are infected with human immunodeficiency virus (HIV).

When should we stop breastfeeding? ›

The American Academy of Pediatrics recommends that mothers feed their babies only breast milk for six months and continue breastfeeding for at least one year. After that, it really depends on how long the mother and child want to continue.

When should you not breastfeed your baby? ›

The U.S. Dietary Guidelines for Americans [PDF-30.6MB] recommend that infants be exclusively breastfed for about the first 6 months, and then continuing breastfeeding while introducing appropriate complementary foods until your child is 12 months old or older.

How do you know if you have an infection while breastfeeding? ›

Breast tenderness or warmth to the touch. Breast swelling. Thickening of breast tissue, or a breast lump. Pain or a burning sensation continuously or while breast-feeding.

What is the main cause of staph infection? ›

Staph infections are caused by staphylococcus bacteria. These types of germs are commonly found on the skin or in the nose of many healthy people. Most of the time, these bacteria cause no problems or cause relatively minor skin infections.

How do you treat an infection in your breast? ›

Treatment for a yeast infection under your breasts may include an antifungal medication. Your healthcare provider may recommend an antifungal cream, ointment or other solution. You can buy many antifungal creams over-the-counter.
Topical antifungal medications include:
  1. Miconazole.
  2. Nystatin.
  3. Clotrimazole.
9 May 2022

Is Staphylococcus aureus an STD or STI? ›

Staph infection is not a sexually-transmitted disease. However, due to the fact that it is on the surface of the skin, it can be passed across but it is not a sexually transmitted disease.

Who is at risk for Staphylococcus aureus? ›

Populations at risk for Staphylococcus aureus infection

Anyone can develop a staph infection, although certain groups of people are at greater risk, including people with chronic conditions such as diabetes, cancer, vascular disease, eczema, lung disease, and people who inject drugs.


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