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Updated: Oct 24, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Breastfeeding and Risk of Late-Onset Group B Streptococcal Disease
Natasha S Ching1,2,3, Jim P Buttery4,2,5,6, Emily Lai4,7
1Departments of Infection and Immunity natasha.ching@monash.edu.
Insights
Breastfeeding is not linked to an increased risk of late-onset group B Streptococcus disease (LOGBS). Testing breast milk for GBS is not recommended during a first LOGBS episode.
Area of Science:
- Neonatal health
- Infectious diseases
- Microbiology
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal sepsis globally.
- Late-onset GBS disease (LOGBS) and its risk factors require further understanding.
- GBS presence in breast milk has raised concerns about breastfeeding safety.
Purpose of the Study:
- To investigate the association between breast milk exposure and the risk of LOGBS.
- To address concerns regarding breastfeeding safety in the context of GBS.
Main Methods:
- A case-control study was conducted using 11 years of data (2007-2017) across 4 hospital networks in Victoria, Australia.
- 92 LOGBS cases were matched with 368 controls based on age, gestation, and other factors.
- Feeding status, including breast milk exposure, was assessed for cases and controls.
Main Results:
- No significant association was found between breast milk exposure and LOGBS (odds ratio 1.2, 95% CI 0.7-2.3).
- 78.3% of LOGBS cases were exposed to breast milk compared to 74.5% of controls.
Conclusions:
- Breastfeeding is not associated with an increased risk of LOGBS.
- Routine testing of breast milk for GBS is not recommended for infants with a first episode of LOGBS.
Background:
Group B Streptococcus (GBS) is a major contributor to neonatal sepsis worldwide. Late-onset group B Streptococcus disease (LOGBS) and its risk factors remain poorly understood. The isolation of GBS from breast milk has been described in cases of LOGBS. This potential association has raised concerns for mothers and clinicians regarding the safety of ongoing breastfeeding. In this study, we aimed to investigate whether exposure to breast milk is associated with increased risk of LOGBS.
Methods:
A case-control study of LOGBS was conducted across 4 hospital networks in Victoria, Australia, including the 2 major tertiary pediatric centers in the state, to evaluate 11 years of data (2007-2017). Cases were captured initially from microbiology databases and recaptured with International Classification of Diseases discharge coding. Each case patient was matched with 4 controls to assess feeding status. Patients were matched for chronological age, gestation, discharge status, recruitment site, and calendar year.
Results:
We identified 92 cases of LOGBS: 73 cases on initial capture and 76 cases on the recapture analysis. Case patients were matched with 368 controls: 4 controls to each patient. Seventy-two patients were exposed to breast milk at the time of LOGBS (78.3%), compared with 274 controls (74.5%; odds ratio 1.2 [95% confidence interval 0.7-2.3]).
Conclusions:
Breastfeeding was not associated with increased risk of LOGBS. Breast milk should not be tested for GBS during a first episode of LOGBS.
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