Q: If a mother tested positive for TB (enlargement of lymph nodes at neck), can she continue breastfeeding her 4 months old child?

A:Breastfeeding should continue while the mother is being treated with the first-line anti-tuberculosis drugs because the concentrations of these drugs in breast milk are too small to produce toxicity in the nursing newborn. For the same reason, drugs in breast milk are not an effective treatment for TB disease or LTBI in a nursing infant. Breastfeeding women taking INH should also take pyridoxine (vitamin B6) supplementation. Since the infection is not an open one, i.e. in the lungs, with the discharge of mycobacteria in the environment, it might not be a risk for the infant. However, an evaluation by a child specialist is recommended.