What are the dangers of breastfeeding your newborn if you are a carrier of hepatitis C?

D.B.

Hepatitis C is a chronic (persistent) infection of the liver, primarily acquired through exposure to contaminated blood. In the past, blood transfusions were a common source of the infection, but now (as a result of screening donated blood for the virus), this rarely occurs. One very common way in which hepatitis C virus (HCV) is spread today is through the sharing of needles and syringes by intravenous drug abusers. The virus also is transmitted through sexual intercourse, though not as commonly as are two other viral infections, hepatitis B or HIV (the virus that causes AIDS). Occasionally, people sharing a household with someone with hepatitis C are infected through contact with contaminated blood. There also are some people infected with the virus who have no obvious route of exposure.

HCV also can be spread from a mother to her baby, during childbirth or in the uterus (womb). The overall risk of transmission from mother to baby is about 5 percent. Health authorities currently have no recommendations for the treatment of pregnant women to reduce the baby's risk of infection. Diagnosing HCV infection in a newborn can be difficult, because the diagnostic test used for adults, which detects antibodies formed by the body in response to HCV infection, is unsuitable for newborns. The reason for this is that some of an infected mother's antibodies can pass from her to the fetus during pregnancy, which may result in a false positive reading (meaning the antibody test can sometimes indicate that an uninfected baby has HCV).

In answer to your specific question, there currently is no evidence that breastfeeding spreads hepatitis C, and the Centers for Disease Control and Prevention (CDC) do not recommend that women with HCV infection abstain from breastfeeding. However, the CDC do recommend that a woman consider abstaining if her nipples are bleeding or cracked.