Transmission of Cytomegalovirus (CMV) through Human Milk

Are New Breastfeeding Policies Required for Preterm Infants?
  • Andrea Willeitner
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 554)

Abstract

Nine out of ten mothers with positive cytomegalovirus (CMV) serology shed CMV in their milk at some time during lactation. CMV is transmitted readily through human milk. Although the majority of acquired CMV infections cause little or no symptoms, there is an association between CMV infection and severe disease in small premature infants. Pasteurization damages some of the anti-infective properties of untreated human milk but is the only reliable and feasible method to destroy CMV infectivity. The current practice of feeding untreated human milk may require reevaluation for seropositive mothers of very immature infants.

Keywords

Neurol Neutropenia Thrombocytopenia Trop Barb 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ahlfors K, Ivarsson SA. Cytomegalovirus in breast milk of Swedish milk donors. Scand J Infect Dis 1985;17:11–13.PubMedCrossRefGoogle Scholar
  2. Ballard RA, Drew WL, Hufhagle KG, Riedel PA. Acquired cytomegalovirus infection in preterm infants. Am J Dis Child 1979;133:482–485.PubMedGoogle Scholar
  3. Bjorksten B, Burman LG, De Chateau P, Fredrikzon B, Gothefors L, Hernell O. Collecting and banking human milk: to heat or not to heat? Br Med J 1980;281:765–769.PubMedCrossRefGoogle Scholar
  4. Bryant P, Morley C, Garland S, Curtis N. Cytomegalovirus transmission from breast milk in premature babies: does it matter? Arch Dis Child Fetal Neonatal Ed 2002;87:F75–77.PubMedCrossRefGoogle Scholar
  5. Doerr HW. Cytomegalovirus infection in pregnancy. J Virol Methods 1987;17:127–132.PubMedCrossRefGoogle Scholar
  6. Dworsky M, Stagno S, Pass RF, Cassady G, Alford C. Persistence of cytomegalovirus in human milk after storage. J Pediatr 1982;101:440–443.PubMedCrossRefGoogle Scholar
  7. Dworsky M, Yow M, Stagno S, Pass RF, Alford C. Cytomegalovirus infection of breast milk and transmission in infancy. Pediatrics 1983;72:295–299.PubMedGoogle Scholar
  8. Friis H, Andersen HK. Rate of inactivation of cytomegalovirus in raw banked milk during storage at -20 degrees C and pasteurisation. Br Med J (Clin Res Ed) 1982;285:1604–1605.CrossRefGoogle Scholar
  9. Gambarotto K, Ranger-Rogez S, Aubard Y, Piver P, Duffetelle B, Delpeyroux C, Roussanne MC, Nicot T, Denis F. [Primary cytomegalovirus infection and pregnant women: epidemiological study on 1100 women at Limoges]. Pathol Biol (Paris) 1997;45:453–461.Google Scholar
  10. Gentile MA, Boll TJ, Stagno S, Pass RF. Intellectual ability of children after perinatal cytomegalovirus infection. Dev Med Child Neurol 1989;31:782–786.PubMedCrossRefGoogle Scholar
  11. Goldblum RM, Dill CW, Albrecht TB, Alford ES, Garza C, Goldman AS. Rapid high-temperature treatment of human milk. J Pediatr 1984;104:380–385.PubMedCrossRefGoogle Scholar
  12. Hamprecht K, Maschmann J, Vochem M, Dietz K, Speer CP, Jahn G. Epidemiology of transmission of cytomegalovirus from mother to preterm infant by breastfeeding. Lancet 2001;357:513–518.PubMedCrossRefGoogle Scholar
  13. Hernandez J, Lemons P, Lemons J, Todd J. Effect of storage processes on the bacterial growth-inhibiting activity of human breast milk. Pediatrics 1979;63:597–601.PubMedGoogle Scholar
  14. Jonkhoff-Slok TW, Veenhoven RH, de Graeff-Meeder ER, Buller HA. An immunocompetent infant with cow’s milk allergy and cytomegalovirus colitis. Eur J Pediatr 1997;156:528–529.PubMedCrossRefGoogle Scholar
  15. Kumar ML, Jenson HB, Dahms BB. Fatal staphylococcal epidermidis infections in very low-birth-weight infants with cytomegalovirus infection. Pediatrics 1985;76:110–112.PubMedGoogle Scholar
  16. Liebhaber M, Lewiston NJ, Asquith MT, Olds-Arroyo L, Sunshine P. Alterations of lymphocytes and of antibody content of human milk after processing. J Pediatr 1977;91:897–900.PubMedCrossRefGoogle Scholar
  17. Maschmann J, Hamprecht K, Dietz K, Jahn G, Speer CP. Cytomegalovirus infection of extremely low-birth weight infants via breast milk. Clin Infect Dis 2001;33:1998–2003.PubMedCrossRefGoogle Scholar
  18. May JT. Microbial contaminants and antimicrobial properties of human milk. Microbiol Sci 1988;5:42–46.PubMedGoogle Scholar
  19. Minamishima I, Ueda K, Minematsu T, Minamishima Y, Umemoto M, Take H, Kuraya K. Role of breast milk in acquisition of cytomegalovirus infection. Microbiol Immunol 1994;38:549–552.PubMedGoogle Scholar
  20. Mosca F, Pugni L, Barbi M, Binda S. Transmission of cytomegalovirus. Lancet 2001;357:1800.PubMedCrossRefGoogle Scholar
  21. Narayanan I, Prakash K, Murthy NS, Gujral W. Randomised controlled trial of effect of raw and holder pasteurised human milk and of formula supplements on incidence of neonatal infection. Lancet 1984;2:1111–1113.PubMedCrossRefGoogle Scholar
  22. Pana A, Santi AL, Grassi M, Divizia M, Assumma M, Carratu A. On the presence of cytomegalovirus in the milk of normal women; correlation between breast feeding and virus excretion in infants. Boll 1st Sieroter Milan 1981;60:85–88.Google Scholar
  23. Paryani SG, Yeager AS, Hosford-Dunn H, Johnson SJ, Malachowski N, Ariagno RL, Stevenson DK. Sequelae of acquired cytomegalovirus infection in premature and sick term infants. J Pediatr 1985;107:451–456.PubMedCrossRefGoogle Scholar
  24. Peckham CS. Cytomegalovirus in the neonate. J Antimicrob Chemother 1989;23 Suppl E:17–21.PubMedCrossRefGoogle Scholar
  25. Peckham CS, Johnson C, Ades A, Pearl K, Chin KS. Early acquisition of cytomegalovirus infection. Arch Dis Child 1987;62:780–785.PubMedCrossRefGoogle Scholar
  26. Richter D, Hampl W, Pohlandt F. Vertical transmission of cytomegalovirus, most probably by breast milk, to an infant with Wiskott-Aldrich syndrome with fatal outcome. Eur J Pediatr 1997;156:854–855.PubMedCrossRefGoogle Scholar
  27. Sharland M, Khare M, Bedford-Russell A. Prevention of postnatal cytomegalovirus infection in preterm infants. Arch Dis Child Fetal Neonatal Ed 2002;86:F140.PubMedCrossRefGoogle Scholar
  28. Shen CY, Chang SF, Chao MF, Yang SL, Lin GM, Chang WW, Wu CW, Yen MS, Ng HT, Thomas JC, et al. Cytomegalovirus recurrence in seropositive pregnant women attending obstetric clinics. J Med Virol 1993;41:24–29.PubMedCrossRefGoogle Scholar
  29. Stagno S. Cytomegalovirus. In: Remington JS, Klein JO, editors. Infectious Diseases of the Fetus and Newborn Infant. Philadelphia: WB Saunders, 1995.Google Scholar
  30. Tantivanich S, Suphadtanaphongs V, Siripanth C, Desakorn V, Suphanit I, Phromin S, Panakitsuwan S, Amarapand P. Prevalence of cytomegalovirus antibodies among various age groups of Thai population. Southeast Asian J Trop Med Public Health 1999;30:265–268.PubMedGoogle Scholar
  31. Vochem M, Hamprecht K, Jahn G, Speer CP. Transmission of cytomegalovirus to preterm infants through breast milk. Pediatr Infect Dis J 1998;17:53–58.PubMedCrossRefGoogle Scholar
  32. Welsh JK, Arsenakis M, Coelen RJ, May JT. Effect of antiviral lipids, heat, and freezing on the activity of viruses in human milk. J Infect Dis 1979;140:322–328.PubMedCrossRefGoogle Scholar
  33. Wu J, Tang ZY, Wu YX, Li WR. Acquired cytomegalovirus infection of breast milk in infancy. Chin Med J (Engl) 1989;102:124–128.Google Scholar

Copyright information

© Springer Science+Business Media New York 2004

Authors and Affiliations

  • Andrea Willeitner
    • 1
  1. 1.Neonatal/Perinatal Medicine, Meriter HospitalUniversity of Wisconsin-MadisonMadisonUSA

Personalised recommendations