ArticlePediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology2021
Revisiting Koch's postulate to determine the plausibility of viral transmission by human milk.
Article in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- In Vivo Risk Assessment of Yellow Fever Virus Transmission Through Breastfeeding, and Mechanistic Insights.The Journal of infectious diseases · 2026Article
- Increased CSF volume, altered brain development and emotional reactivity after postnatal Zika virus infection in infant rhesus macaques.bioRxiv : the preprint server for biology · 2026Article
- Is health, growth and development impaired in children who are Hepatitis B-exposed but uninfected?PLOS global public health · 2025Review
- Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances.Children (Basel, Switzerland) · 2024Article
- Viruses and Human Milk: Transmission or Protection?Advances in nutrition (Bethesda, Md.) · 2023Review
- Milk Transmission of Mammalian Retroviruses.Microorganisms · 2023Review
- Parental factors that impact the ecology of human mammary development, milk secretion, and milk composition-a report from "Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)" Working Group 1.The American journal of clinical nutrition · 2023Article
- Recommendations for breastfeeding during Coronavirus Disease 2019 (COVID-19) pandemic.International breastfeeding journal · 2022Review
- Impact of the Coronavirus Disease (COVID-19) Pandemic on Neonatal Nutrition: Focus on Low- and Middle-Income Countries.Current tropical medicine reports · 2022Review
- Article
- Mother-to-Child Transmission of Arboviruses during Breastfeeding: From Epidemiology to Cellular Mechanisms.Viruses · 2021Review
- Revisiting Koch's postulate to determine the plausibility of viral transmission by human milk.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 5 countries.
Funding
Abstract
As breastfeeding is of utmost importance for child development and survival, identifying whether breast milk is a route of transmission for human viruses is critical. Based on the principle of Koch's postulate, we propose an analytical framework to determine the plausibility of viral transmission by breast milk. This framework is based on five criteria: viral infection in children receiving breast milk from infected mothers; the presence of virus, viral antigen, or viral genome in the breast milk of infected mothers; the evidence for the virus in breast milk being infectious; the attempts to rule out other transmission modalities; and the reproduction of viral transmission by oral inoculation in an animal model. We searched for evidence in published reports to determine whether the 5 criteria are fulfilled for 16 human viruses that are suspected to be transmissible by breast milk. We considered breast milk transmission is proven if all 5 criteria are fulfilled, as probable if 4 of the 5 criteria are met, as possible if 3 of the 5 criteria are fulfilled, and as unlikely if less than 3 criteria are met. Only five viruses have proven transmission through breast milk: human T-cell lymphotropic virus 1, human immunodeficiency virus, human cytomegalovirus, dengue virus, and Zika virus. The other 11 viruses fulfilled some but not all criteria and were categorized accordingly. Our framework analysis is useful for guiding public health recommendations and for identifying knowledge gaps amenable to original experiments.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.