What is the appropriate action for a mother with active TB and a positive culture during breastfeeding?

In the case of a mother with active tuberculosis (TB) and a positive culture during breastfeeding, the safest recommendation is to discontinue breastfeeding. This is primarily due to the risk of transmission of the TB bacteria to the infant through breast milk or through close contact during breastfeeding, especially when the mother is not on effective treatment or when precautions cannot be reliably maintained.

The risk to the infant is significant because TB is an airborne disease, and while the bacteria are not transmitted through breast milk, close proximity during breastfeeding could potentially expose the infant to the airborne particles. Hence, prioritizing the infant’s safety is crucial, and the best action is to avoid breastfeeding until the mother is adequately treated and no longer contagious.

Although options such as continuing breastfeeding with precautions may seem appealing, they do not sufficiently mitigate the risk of transmission in this context. Using a breast pump could help collect milk, but without proper management of the mother's condition, the inherent risks remain. Therefore, the most responsible and cautious action is to stop breastfeeding to prevent any potential health risks to the child.