Malaria

Malaria is a mosquito-borne disease caused by a parasite. The vast majority of cases in the United States occur in travelers and immigrants returning from countries where malaria transmission occurs, including sub-Saharan Africa and South Asia.

Can malaria be transmitted to an infant through a mother’s breast milk?

No. However, a breastfeeding mother who plans to travel to a geographic region where malaria is prevalent is advised to take every precaution to reduce her risk of infection. Standard preventive approaches include mosquito avoidance measures, such as insect repellent, and prophylactic antimalarial medications. When using insect repellant, a breastfeeding mother should avoid applying insect repellents under their clothes or to the nipple area and should wash their hands before holding and breastfeeding her infant.

Are prophylaxis antimalarial medications safe to take while breastfeeding?

Most prophylaxis antimalarial medications are safe for nursing mothers. Prophylaxis antimalarial medications are taken before, during, and after travel to an area with malaria to prevent malaria transmission. Breastfeeding mothers traveling to malaria-endemic regions should adhere to the standard recommended dosage of prophylaxis antimalarial medications appropriate for the country they are visiting. The breastfeeding child also needs his or her own antimalarial drug. See CDC’s Yellow Book Chapter 4 Malaria for a specific list of prophylaxis antimalarial drugs, recommended dosages, and safety during lactation.

If a mother is taking a prophylaxis antimalarial drug and breastfeeding, will her infant be protected from malaria through the transfer of medication in her breast milk?

No. The quantity of drug transferred in breast milk is not enough to provide protection against malaria for the infant. The breastfeeding infant needs his or her own prophylaxis antimalarial drug.

Is it safe for an infant to breastfeed while his or her mother is taking medication to treat malaria?

Yes, mothers who are taking antimalarial medications may continue to breastfeed, provided they are healthy enough to do so.  However, some medications used to treat malaria are not safe for breastfeeding infants who weigh less than 5 kg (11 lb), and should be avoided in breastfeeding mothers. Providers need to be aware if a mother is breastfeeding in order to prescribe the appropriate medication. Mothers who are diagnosed with malaria should begin appropriate treatment as soon as possible.