Lyme Disease During Pregnancy and Breastfeeding: What You Need to Know
Can Lyme disease affect pregnancy or be passed to a baby?
Possibly. While many pregnancies have normal outcomes, some studies suggest that untreated Lyme disease during pregnancy may increase the risk of complications.
Early recognition and appropriate treatment are key to reducing risk.
For a broader overview, see Lyme disease symptoms.
Lyme Disease and Pregnancy
If a woman develops Lyme disease during pregnancy, she should notify her physician promptly.
Some studies have described adverse outcomes, particularly when infection occurs early in pregnancy.
- Stillbirth has been reported in first-trimester infections
- Cases of prematurity and fetal abnormalities have been described
- Findings have included syndactyly, cortical blindness, and rash
In one report, spirochetes consistent with Borrelia burgdorferi were identified in fetal tissues.
However, not all studies show increased risk.
A large study of 2,000 women with prior Lyme disease did not show increased rates of fetal death or low birth weight.
This suggests that risk may depend on timing, treatment, and individual factors.
Can Lyme Disease Be Transmitted During Pregnancy?
Transmission of Lyme disease from mother to fetus has been reported in some cases, but the overall risk remains unclear.
There is insufficient evidence to determine how often transmission occurs.
Early diagnosis and treatment appear to reduce the likelihood of complications.
Antibiotic Treatment During Pregnancy
Choosing antibiotics during pregnancy requires careful consideration.
Medications used in pregnancy may include:
- Amoxicillin
- Cefuroxime
- Azithromycin
- Intravenous ceftriaxone (in certain cases)
Treatment decisions should be guided by the patient’s clinician.
Breastfeeding and Lyme Disease
Can Lyme disease be transmitted through breast milk?
According to the CDC, there are no confirmed reports of Lyme disease transmission through breast milk.
However, data remain limited.
Certain antibiotics—such as tetracyclines—are generally avoided during breastfeeding due to potential side effects.
Breastfeeding decisions should be individualized and discussed with a clinician.
Babesia and Pregnancy
Babesia, another tick-borne infection, has been transmitted from mother to infant during pregnancy.
Cases have been reported where newborns developed Babesia weeks after birth.
This highlights the importance of considering co-infections during pregnancy.
Learn more about Babesia infection.
Why This Topic Is Complex
Research on Lyme disease in pregnancy is limited and sometimes conflicting.
- Some studies report complications
- Others show outcomes similar to the general population
- Long-term outcomes are not well studied
This uncertainty makes individualized care essential.
Clinical Takeaway
Lyme disease during pregnancy requires prompt evaluation and appropriate treatment.
While many pregnancies have normal outcomes, delayed diagnosis may increase the risk of complications.
Breastfeeding appears safe in most cases, but decisions should be made with clinical guidance.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Interesting, that is not what I was told when I was pregnant. I was being treated by one of the top Lyme Doctors(He is no longer practicing but may still be doing research) and he was very clear that breastfeeding was not an option. He also indicated that most women feel great during pregnancy and had a horrible time after. My kids are 22, 19, and 15 and I was told I could not breastfeed. During my first pregnancy, I was not on antibiotics and after the pregnancy, I had a horrible relapse. In my other two pregnancies, I was on antibiotics and did not have nearly the same reaction. I would be curious as to what has warranted the change of thinking esp since the number of mothers and studies seem rather low. Overall, I have trouble trusting the CDC when it comes to anything related to Lyme and tick borne diseases. I hope the experts in the field are not relying only on the CDC
I have not seen published data to advise my patients not to breast feed. I have colleagues who continued to advise their patients not to breast feed. There advise could be out of cases they have seen or an abundance of concern. I choose to discuss options with the mother and father until data is available.