Hepatitis B and Breastfeeding

05.24.2011

A recent meta analysis of ten studies concluded that following proper maternal immunization, that Hepatitis B (HBV) is not transferred from mother to child. The study reviewed articles published between January 1, 1990 to August 31,2010. Studies included had to meet strict inclusion criteria and all studies were peer reviewed. Of the ten studies chosen, all were clinical controlled trials. Primary outcomes included mother –to- child transmission of HBV infection at 6-12 months and hepatitis B surface antibody results at 6-12 months. Secondary outcomes included intrauterine infection and maternal blood and breast milk infectiousness. There were 751 infants in the breastfeeding group and 873 infants in the non-breastfeeding group. The odds ratio of mother to child transmission of hepatitis B virus (as indicated by peripheral blood hepatitis B surface antigen or hepatitis B virus DNA positivity) was 0.86. An odds ratio of 1 or less means that the odds of an event is the same in the treatment and control group. Based on these results, the risk of HBV transmission from mother to child was actually lower than in those women who did not breastfeed. This study clearly suggests that breastfeeding should continue even if a mother is Hepatitis B positive. The only caveat to this is, if the mother has cracked or bleeding nipples or lesions on her breasts, she should discontinue breastfeeding until the lesions are healed. According to this study, breastfeeding does not contribute to mother to child transmission of Hepatitis B if the child has received proper immunoprophylaxis at birth (both hepatitis B vaccine and immunoglobulin).

For the complete article, please visit: http://archpedi.ama-assn.org/cgi/content/abstract/archpediatrics.2011.72

Maria Milla MD.

Thomas W. Hale Ph.D.