This letter discusses whether monkeypox can be transmitted through breast milk, based on previous published articles. The authors evaluate the possibility of transmission of monkeypox from breast milk. The criteria for determining likelihood are those they previously proposed in PAI. Cases of monkeypox infection have recently increased rapidly, raising concerns about the risk of mother-to-child transmission. Even though data supporting transmission of this virus through breast milk are still sparse, there is a risk of contact transmission, and WHO recommends that mothers in the active phase of monkeypox infection consider isolation to prevent transmission to their infants. I appreciate that the authors' discussion is timely and encourages infection prevention actions based on scientific evaluation. However, I would like to request that the following two points be reconsidered before publication.
1) According to the Redbook, smallpox is associated with a high mortality rate at less than one year of age. It would be more appealing to readers if you mention what is thought about monkeypox in the introduction.
2) To strengthen the message of this letter, it might be helpful to clarify the answer to the question of whether breast milk collected from isolated mothers can be given to infants.
An additional point
1) Do we need a comma after 'However' on line 80?