I recently saw a 6-month-old with HFMD.  His mother continued to breastfeed.  Two to three days after the son's rash appeared, mom developed lesions on the hands, feet and mouth but also on her breasts, genitals and scalp. I saw them again yesterday for a well-check and she is breastfeeding him without issue though she does say that her spots do hurt. She also said that her mother, the baby's grandmother, has developed the rash as well. 

It is likely that the mom's breasts have already been exposed to the virus by the time the baby is diagnosed so it would really be too late to stop breastfeeding to prevent transmission to mom's breasts.

I did not realize that this is rare until reading Anne's post. If she hasn't seen it in 20 years it must not occur too frequently. Since reading Anne's post I called mom and left a message asking if she still has the breast lesions if she will take a photo for my teaching files!

Amy Grawey, MD

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