There have been no reports of a baby contracting hepatitis C as a result of breastfeeding. However, if a person’s nipples are bleeding or cracked while breastfeeding, the hepatitis C virus can be transmitted (HCV).
The Centers for Disease Control and Prevention (CDC) provides this information.
HCV causes hepatitis C, which is a liver disorder. It is transmitted by coming into contact with the infected person’s blood. As a consequence, it cannot be transmitted solely by breast milk.
In this article, we’ll look into whether breastfeeding is healthy for someone who has HCV, what to do if the nipples are broken or bleeding, and other preventative measures caregivers may take.
How safe is breastfeeding ?
There have been no reports of a baby contracting HCV from human milk. As a result, it appears that giving breast milk to babies is healthy, even if the person feeding them has hepatitis C.
Human breast milk appears to have the ability to deactivate HCV. As a result, caregivers who breastfeed, chest feed, or bottle feed using their own milk do not need to be concerned about the virus spreading.
There is currently insufficient evidence to establish whether cracked nipples can transmit HCV.
If a person’s nipples are cracked or bleeding, it’s theoretically possible for a baby to drink HCV-infected blood. This is so if the baby is breastfed or the mother expresses milk into a bottle.
However, the risk level is unknown. As a result, the CDC recommends that people with hepatitis C who have broken or bleeding nipples temporarily avoid feeding their baby with their own milk.
Until the nipples heal, people should:
- Since their milk can be mixed with blood, they should convey and then discard it safely.
- To feed the baby, turn to donor human milk or formula.
- If required, seek assistance from a lactation specialist, especially to devise a strategy for maintaining their milk supply.
In addition to the precautions mentioned above, parents and caregivers with HCV should take additional steps to help prevent the virus from spreading to their children.
Preventative measures in general
Do not share personal objects with them, such as nail scissors or clippers, toothbrushes, or jewellery that reaches the skin, such as earrings, to help avoid HCV transmission from a caregiver to an infant.
Disinfect any household, personal, or baby products that are likely to come into contact with blood on a regular basis.
In the event of an accident
If a caregiver sustains an injury, they must:
- Use disposable cloths or paper towels to cover up any spilt blood right away
- Separate the cloths or towels and place them in a sealed container
- Using bleach, sterilise the area before rinsing it with water
When a caregiver has a cut or wound, they must also:
- Use bandages, sterile dressings, or other protective coverings to fully cover any open wounds or areas of broken skin
- Kissing a baby should be avoided until any wounds or sores on the lips or inside the mouth have healed
- If either the baby or the caregiver’s hand has a wound or broken skin, stop holding hands with them
- Band-aids, wound dressings, sanitary or menstrual items should all be placed in a separate sealed bag out of reach of children
In case of exposure to blood
If a baby had come into contact with the caregiver’s blood:
- Wash them as soon as possible with warm running water and soap, or with an antiviral product.
- Remove all of the blood, paying special attention to hard-to-reach places, and pat dry with a new, clean towel.
- Any personal products that may have come into contact with the blood, such as bedding, towels, eating utensils, and drinkware, should be cleaned and disinfected.
It’s helpful to know what types of HCV tests are available and what they mean before pursuing testing.
There are two types of HCV examinations. Antibody or polymerase chain reaction (PCR) tests determine whether a person’s blood contains HCV antibodies. Antibodies are proteins produced by the body to kill or deactivate certain viruses and bacteria.
A positive antibody test indicates that someone has had HCV at some stage in their lives. However, this does not always imply that they are infected.
Another form of test is the PCR test. These check to see if the virus is still reproducing in the body. This means that the infection is active.
When would adults be tested?
If a parent or caregiver suspects they have HCV but isn’t positive, they should get tested right away. Since HCV sometimes causes no symptoms at first, it’s critical to determine if anyone is a carrier.
People should be screened for HCV if they have any of the following symptoms:
- They believe they might have been infected with HCV by someone else
- They experience exhaustion, fever, abdominal pain, and trouble concentrating
- They use medications that can be injected, such as heroin
After giving birth, people with HCV should have their HCV RNA levels checked. This is because HCV seems to clear up on its own in certain people after they give birth.
A 2017 study from Cairo University in Egypt found that 12 months after giving birth, 26.9% of people with HCV had undetectable levels of the virus’s DNA in their blood. This tends to be linked to a particular genetic mutation.
When will children be able to be tested?
A baby born to someone who has HCV should be tested when they are 18 months old or older, according to most health authorities.
This is due to the presence of maternal antibodies in the blood of newborns. These HCV antibodies will be detected by a conventional HCV test, resulting in a false-positive result.
If parents or caregivers are worried about a baby’s HCV infection, testing may be available as early as 3 months of age, but this raises the likelihood of a false-positive result. Doctors use a PCR test instead of an antibody test in these situations.
Children over the age of two are tested for HCV in the same way as adults are. If a child tests positive, therapy will begin until they hit the age of three.
Treatment when breastfeeding
Direct-acting antivirals (DAAs) are the most commonly prescribed drugs for chronic hepatitis C. DAAs are typically taken for 8–12 weeks by most people who aren’t pregnant or breastfeeding. Current treatments have a success rate of 90% or higher.
However, there isn’t enough evidence to suggest that DAAs are healthy to use during pregnancy or breastfeeding. Much less research has been done on the impact of DAAs and other HCV therapies on infants.
DAAs have been shown in animal studies to cross the placenta and enter breast milk. However, according to a 2019 report, DAAs may be safe to use during the second or third trimester of pregnancy, as well as when breastfeeding.
Doctors usually wait until a person finishes feeding a baby with breast milk before starting DAA treatment until more proof proving DAAs are safe during breastfeeding is available.
Some good questions to ask a doctor
If a mother wants to breastfeed her child, she should obtain assistance and support from a doctor or lactation specialist. Such questions to consider are:
- What are the safest ways for me to breastfeed, chest feed, or pump breast milk?
- Is there something I can purchase, such as medical equipment or cleaning supplies?
- Is there any new evidence on the protection of breastfeeding or HCV avoidance for people with the virus?
- What do I do if I suspect my child has been exposed to HCV?
- Is it necessary to test my baby for HCV?
- What happens if they get a positive test result?
- When will I be able to start treatment?
- What are the treatment options?
As long as they don’t have broken or bleeding nipples, people with HCV can safely breastfeed, chest feed, or feed their bottled milk to an infant. If this happens, avoid breastfeeding and temporarily turn to donor or formula milk.
- Freriksen, J. J. M., et al. (2019). Review article: Direct-acting antivirals for the treatment of HCV during pregnancy and lactation – implications for maternal dosing, foetal exposure, and safety for mother and child.
- Hepatitis C and breastfeeding: Is it safe? https://www.medicalnewstoday.com/articles/hepatitis-c-and-breastfeeding
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