May 24, 2011
A new study shows that new mothers infected with the blood-borne hepatitis B virus (HBV) can safely breastfeed their babies, provided proper immunoprophylaxis methods are taken.
Dr. Zhongjie Shi, of Philadelphia's Temple University, and colleagues conducted a systematic review of prospective studies to clarify the role of breastfeeding in mother-to-child HBV transmission. Data from 10 studies, all conducted in China, compared HBV rates in the babies of more than 1,000 mothers with the virus; about half these women breastfed their babies.
To prevent hepatitis B transmission, babies are vaccinated against HBV at birth and given another injected medicine soon after birth. Infants also are vaccinated two or three more times during the first few months of life.
The review showed that by their first birthday, 31 babies out of the 637 with breastfeeding mothers were HBV-positive. By comparison, 33 babies of 706 mothers who did not breastfeed became infected. Most of the infected infants had contracted HBV during pregnancy or childbirth, the researchers noted. Blood is the primary vector for mother-to-child transmission, followed by amniotic fluid and vaginal secretions, said Shi.
Even in HBV-infected mothers, "breastfeeding should be recommended as a valuable source of nutrition to infants," said Shi. However, mothers should avoid the practice if they have cracked or bleeding nipples or lesions on their breasts, since this could transmit the virus more easily, the researchers said.
According to Shi, the study results "are most valuable in developing countries and areas with high [HBV] prevalence or heavy population, such as India, China, [and] southeast Asia."
The study, "Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus," was published early online in the Archives of Pediatrics & Adolescent Medicine (2011; doi:10.1001/archpediatrics.2011.72).