Last update: June 29, 2020
Minimal risk for breastfeeding and infant.
In 1975, before there was universal neonatal immunization against Hepatitis B (HB), vertical transmission frequency (mother to child) of 53% in breastfed infants and 60% in non-breastfed infants was recorded (Beasley 1975), suggesting that breastfeeding did not play an important role in the vertical transmission of HB.
In 369 children of mothers with chronic HB who were vaccinated at birth, there was no case of HB transmission among the 101 who were breastfed and there were 9 cases (3%) of transmission among the 268 fed artificial formula (Hill 2002).
Although the surface antigen of the hepatitis B virus (HBsAg) is detected in breastmilk, there is no difference in the frequency of transmission from mothers with HBsAg to their breastfed children compared to those who do not breastfeed.
There is widespread agreement among medical associations and expert consensus that maternal hepatitis B is not transmitted to the infant through breastmilk and therefore does not contraindicate breastfeeding (Mammas 2017, Fouquet 2016, Visvanathan 2016, Dionne 2016, Sogni 2015, Dunkelberg 2014, NIHCE-UK 2013 , SFP 2013, Bzowej 2012, Borgia 2012, CDC 2010, Bzowej 2010, Fiore 2010, Larke 1977).
Prior to neonatal vaccination, vertical transmission through breastfeeding was never proven (Castillo 2017) and neither was it after adequate neonatal immunoprophylaxis with the administration of anti-HB vaccine and HB-immunoglobulin to the newborn of an HBsAg+ mother (Xiao 2017, Yi 2016, SMFM 2016, García 2015, Lamberth 2015, Red Book 2012 p 389, Zhang 2014 and 2014, Geeta 2013, Tran 2012, Shi 2011, Pol 2011, Zheng 2011, Sookoian 2006, Pronczuk 2002, CDC 1990, de Martino 1985 ), even in mothers with high infectivity (Kumar 2012, Zheng 2011).
Several antiviral drugs used to treat hepatitis B do not contraindicate breastfeeding (Wong 2018, Chamroonkul 2017, Marcellin 2016, NIHCE-UK 2013, Pandhi 2104, Hirnschall 2013, Pol 2011), although some authors recommend stopping treatment while breastfeeding (SMFM2016, Lamberth 2015, Bzowej 2012, Kumar 2012).
It is recommended to talk in each case with the mother due to the ethical and legal problem that is the frequent contraindication of breastfeeding in the technical data sheets of medicines (Rosenthal 2015).
The acceptance among professionals of the compatibility of Hepatitis B and its antiviral treatment with breastfeeding has been gradually gaining ground over recent years (Ahn 2010).
Despite this overwhelming consensus in favor of compatibility, which is also supported by the WHO (Pronczuk 2002) even in cases of non-vaccination (Indian Ped 1997), some countries, such as China, have very low breastfeeding rates among HBsAg+ mothers ( Qiu 2010).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.
Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.
Thank you for helping to protect and promote breastfeeding.
e-lactancia is a resource recommended by Academy of Breastfeeding Medicine from United States of America
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM