I have been diagnosed with asymptomatic Chronic Hepatits C.  I'm trying to find out what the current recommendations are in regards to breastfeeding with this illness. My OB seems to feel that I shouldn't breastfeed since not much is really known on whether it can be passed to the baby via the HCV RNA in the breast milk. I'm confused! I really WANT to breastfeed my child if possible, but on the other hand, if there's a possibility that I could transfer this to her, of course I won't.

I've searched medline and most of the articles are still saying that 'as of now' there are no contraindications to breastfeeding...but what if.... Thank you for any advice or recommendations you may have for a 43 yr old first time mom who has been TTC for 8 yrs!




 

I am replying to your question about hepatitis C that you posted to the Breastfeeding.com web site. I am sorry to hear that you have this condition. My best source of information comes from Breastfeeding: A Guide for the Medical Profession by Ruth Lawrence, MD 4th edition, 1994, Mosby Publishers.

Ruth sites two references in her comments on your condition. She feels that it is not safe to breastfeed but the date is 1994. The Committee on Infectious Disease: Report of the Committee on Infectious Disease, AAP Redbook takes that position but it is dated 1988.

Another study sited by Lawrence is Nagata I, Shiraki K, Tanimoto K, et al. "Mother to infant transmission of hepatitis C virus", Journal of Pediatrics, 120:432, 1992. That seemed to relate to the possibility that the baby may get it in utero. The authors did not believe the babies got the disease through breastmilk. To fully understand the study, you would have to read it yourself. They studied 10 carrier mothers. None of the breastmilk samples were positive. The babies had antibody at birth but it gradually disappeared.

If you have found more recent studies on Medline and they say it is not contraindicated, then...

#1 I would read the study carefully and not go on the summary.

#2 Make the decision you feel most comfortable with.

The studies should be well designed and you might want to have a medical professional or college professor that is used to deciphering such things read it as well and tell you their opinion. The problem with studies is that they don't always give us a black and white answer! A good source of info on disease is the CDC (as you probably know already). They should have a web site and you may be able to communicate with someone there. Your health department should have staff that knows how to contact the CDC since they are supposed to do that on other diseases.

I am glad you are researching this yourself because you will be much more comfortable with the choice you make. I hope it will be safe for you to nurse but I really do not know enough about it. You are much more the expert that I. If you have difficulty with nursing (once you start!) then be sure to let us help you! In the meantime, good luck and our very best wishes go to you and your family. Feel free to write back!

Sincerely,

Elaine Matheny, IBCLC





 

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