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Hepatitis A (HAV), B (HBV), and C (HCV)
The potential problem
The various strains of hepatitis, all of which infect the liver, cause symptoms that range from mild to severe. Because hepatitis is a viral infection, you may worry about transmitting the illness through your breast milk.
Hepatitis A (HAV), also known as infectious hepatitis, is a short-term illness with mild symptoms such as loss of appetite, fever, fatigue, and nausea. It's transmitted through contact with infected blood or bowel movements.
Hepatitis B (HBV), also called serum hepatitis, is spread through contact with saliva, mucus, blood, and other body fluids, as well as through contaminated foods and sexual activity. It can produce symptoms similar to –but more long lasting than – those of HAV. It may lead to chronic liver disease or even be fatal.
Hepatitis C (HCV) is spread through infected blood or needles or through sexual contact. The illness often begins as a slight but nagging infection with flu-like symptoms and may eventually result in liver cancer.
Can I breastfeed?
In general, yes.
Hepatitis A is not transmitted by breast milk. It can be treated with gamma globulin, a medication that's safe to take if you're breastfeeding.
Hepatitis B has been found in breast milk. However, because a baby is likely to have been exposed to the virus during pregnancy or delivery, and is immunized at birth, researchers say that infected mothers can safely nurse from the start.
Hepatitis C doesn't appear to be spread through breast milk. But the Centers for Disease Control and Prevention (CDC) recommend that you stop nursing temporarily if you have cracked or bleeding nipples as HCV can be spread through your blood.
If you're HBV-positive: Within 12 hours of birth – and again at between 1 to 2 months and again at 6 months – a baby born to an HBV-infected mom should be fully immunized against the virus. At age 9 to 18 months, the baby should be tested to make sure she is not infected.
If you're HCV-positive: Your symptoms may make you feel quite tired, and you may be inclined to stop nursing. Breastfeeding experts recommend that you continue to nurse, though, because the benefits to your baby are so great and nursing requires less effort on your part than trying to pump or express milk (especially if you can have someone bring the baby to you).
You'll want to take good care of your nipples, though, because if they become cracked and bleed you could transmit HCV to your baby through your blood. If your nipples begin to bleed, you'll have to pump and dump your milk (and bottle-feed your baby formula or donor milk) until they heal.
Talk to your baby’s doctor about any medications you’re taking. Or check Lactmed, the National Institutes of Health’s drugs and lactation database.