Mothers with Hepatitis B Can Safely Breastfeed

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http://www.hivandhepatitis.com/hep_b/news/2011/0524_2011_a.html

Mothers with Hepatitis B Can Safely Breastfeed

SUMMARY

Women with chronic HBV infection can breastfeed with minimal risk of

transmitting the virus to their babies if they use standard prophylactic

therapy, according to a recent review.

By Liz Highleyman

Hepatitis B virus (HBV) is a blood-borne pathogen can be transmitted from

mothers to infants during pregnancy or delivery. Research has shown that use of

prophylactic therapy including hepatitis B immune globulin (HBIG) and HBV

vaccination can prevent infant infection at birth, but transmission via

breastfeeding has been less extensively studied.

As described in the May 2, 2011, advance issue of Archives of Pediatrics and

Adolescent Medicine, Zhongjie Shi from Sun Yat-sen University in Guangzhou,

China, and colleagues performed a systematic review and meta-analysis of studies

looking at the role of breastfeeding in mother-to-child HBV transmission.

The review authors searched medical literature databases including MEDLINE,

EMBASE, Cochrane Library, National Science Digital Library, and China Biological

Medicine Database for relevant studies published between January 1990 and August

2010; they also interviewed experts in the field.

Shi's team selected prospective, peer-reviewed, controlled clinical trials that

examined breastfeeding as a route of HBV exposure. Babies were given HBIG and an

initial HBV vaccine dose soon after birth, with follow-up vaccine doses over the

next several months.

The researchers collected data on HBV intrauterine infection, maternal blood and

breast milk infectiousness, infant immune prophylaxis methods and response, and

occurrence of adverse events.

Results

The analysis included 10 studies that met the inclusion criteria, all done in

China.

These studies involved a total of 751 infants in the breastfeeding group and

873 infants in the non-breastfeeding group.

By the age of 12 months, 31 infants in the breastfeeding group tested positive

for HBV, compared with 33 in the non-breastfeeding group.

According to infant blood tests for hepatitis B surface antigen (HBsAg) or HBV

DNA positivity at age 6 to 12 months, HBV transmission occurred with similar

frequency in the breastfeeding and non-breastfeeding groups (odds ratio 0.86).

According to infant blood hepatitis B surface antibody (anti-HBs) positivity at

6 to 12 months, babies in both groups were equally likely to develop surface

antibodies (odds ratio 0.98).

No adverse events or complications were observed during breastfeeding.

Based on these findings, the study authors concluded, " Breastfeeding after

proper immunoprophylaxis did not contribute to mother-to-child transmission of

HBV. "

Given that the rate of infection was similar in infants in the breastfeeding and

non-breastfeeding groups, the investigators suggested that the small number of

infections likely occurred during pregnancy or delivery. Breastfeeding should

generally be recommended for its nutritional value, they said, but women should

avoid it if they have cracked nipples or sores than could expose babies to

blood.

Investigator affiliations: Third Affiliated Hospital of Sun Yat-sen University,

Guangzhou, China; Department of General Surgery, Second Affiliated Hospital and

Harbin Medical University, Harbin, China; Heilongjiang Academy of Traditional

Chinese Medicine, Harbin, China; Department of Chemistry and Health Science

Center, Temple University, Philadelphia, PA.

5/24/11

Reference

Z Shi, Y Yang, H Wang, et al. Breastfeeding of Newborns by Mothers Carrying

Hepatitis B Virus: A Meta-analysis and Systematic Review. Archives of Pediatrics

and Adolescent Medicine (abstract). May 2, 2011 (Epub ahead of print).

[Guest guest]

http://www.hivandhepatitis.com/hep_b/news/2011/0524_2011_a.html

Mothers with Hepatitis B Can Safely Breastfeed

SUMMARY

Women with chronic HBV infection can breastfeed with minimal risk of

transmitting the virus to their babies if they use standard prophylactic

therapy, according to a recent review.

By Liz Highleyman

Hepatitis B virus (HBV) is a blood-borne pathogen can be transmitted from

mothers to infants during pregnancy or delivery. Research has shown that use of

prophylactic therapy including hepatitis B immune globulin (HBIG) and HBV

vaccination can prevent infant infection at birth, but transmission via

breastfeeding has been less extensively studied.

As described in the May 2, 2011, advance issue of Archives of Pediatrics and

Adolescent Medicine, Zhongjie Shi from Sun Yat-sen University in Guangzhou,

China, and colleagues performed a systematic review and meta-analysis of studies

looking at the role of breastfeeding in mother-to-child HBV transmission.

The review authors searched medical literature databases including MEDLINE,

EMBASE, Cochrane Library, National Science Digital Library, and China Biological

Medicine Database for relevant studies published between January 1990 and August

2010; they also interviewed experts in the field.

Shi's team selected prospective, peer-reviewed, controlled clinical trials that

examined breastfeeding as a route of HBV exposure. Babies were given HBIG and an

initial HBV vaccine dose soon after birth, with follow-up vaccine doses over the

next several months.

The researchers collected data on HBV intrauterine infection, maternal blood and

breast milk infectiousness, infant immune prophylaxis methods and response, and

occurrence of adverse events.

Results

The analysis included 10 studies that met the inclusion criteria, all done in

China.

These studies involved a total of 751 infants in the breastfeeding group and

873 infants in the non-breastfeeding group.

By the age of 12 months, 31 infants in the breastfeeding group tested positive

for HBV, compared with 33 in the non-breastfeeding group.

According to infant blood tests for hepatitis B surface antigen (HBsAg) or HBV

DNA positivity at age 6 to 12 months, HBV transmission occurred with similar

frequency in the breastfeeding and non-breastfeeding groups (odds ratio 0.86).

According to infant blood hepatitis B surface antibody (anti-HBs) positivity at

6 to 12 months, babies in both groups were equally likely to develop surface

antibodies (odds ratio 0.98).

No adverse events or complications were observed during breastfeeding.

Based on these findings, the study authors concluded, " Breastfeeding after

proper immunoprophylaxis did not contribute to mother-to-child transmission of

HBV. "

Given that the rate of infection was similar in infants in the breastfeeding and

non-breastfeeding groups, the investigators suggested that the small number of

infections likely occurred during pregnancy or delivery. Breastfeeding should

generally be recommended for its nutritional value, they said, but women should

avoid it if they have cracked nipples or sores than could expose babies to

blood.

Investigator affiliations: Third Affiliated Hospital of Sun Yat-sen University,

Guangzhou, China; Department of General Surgery, Second Affiliated Hospital and

Harbin Medical University, Harbin, China; Heilongjiang Academy of Traditional

Chinese Medicine, Harbin, China; Department of Chemistry and Health Science

Center, Temple University, Philadelphia, PA.

5/24/11

Reference

Z Shi, Y Yang, H Wang, et al. Breastfeeding of Newborns by Mothers Carrying

Hepatitis B Virus: A Meta-analysis and Systematic Review. Archives of Pediatrics

and Adolescent Medicine (abstract). May 2, 2011 (Epub ahead of print).