Can You Get Hepatitis From Breast Milk?

In recent years, there has been a notable emphasis on promotion and general support for breastfeeding by different institutions and organizations worldwide. This is due to multiple studies that have shown the great importance of human milk in infant nutrition.

Breast milk has a known protective effect in relation to infectious diseases.

However, AIDS pandemic allowed verifying that the virus is transmitted by human milk; a series of controversies have been unleashed on this, other infectious agents and the role of breastfeeding.

Undoubtedly, human milk is the ideal food for the human being in its first months of life. It is not only a natural product, but economic and biochemically balanced according to the needs of the infant in its different stages of growth, an indispensable role in the prevention of diseases and allergies. The production of antimicrobial, anti-inflammatory and immunomodulatory agents is limited in the newborn as part of the overall maturation process. Thus, for example, the production of secretory IgA in the infant begins at 4 months and is fully established at 12 months; the complete repertoire of antibodies was achieved at 24 months, and the T cells of memory at 2 years.

The class of the mother’s parents is at a crucial moment.

The concepts of “enteromamaria circulation” and “broncho-mammary passage” explain the transmission of secretory IgA from the mother to the child through lactation, in the lymphoid centers in the bronchi, as well as in the Peyer’s plaques in the intestine, the antigen is exposed to the producing IgM B cells and, when stimulated, they are transformed into IgA-producing plasma cells. The IgA is transported from the mammary gland circulation to the acini of the mammary gland, and from there the infant receives it. This one receives 0.5 to 1 gram of IgA daily secretory against pathogens such as: E. coli, Shigella, Salmonella, Clostridium difficile, Rotavirus, Cytomegalovirus (CMV), Poliovirus, Giardia, and Candida albicans.

There are anti-inflammatory agents, contained in breast milk, such as acetylhydrolase, an enzyme that degrades platelet aggregation factor, which is attributed protective role in the enterocolitis of prematurity. The epithelial growth factor that is related to early recovery in acute diarrheal disease; and many other immunomodulatory factors such as cytokines that activate T cells and increase the production of IgA, b-casomorphins and prolactin. They all contribute to the protective effect of breast milk.

Active tuberculosis contraindicates breastfeeding due to the possibility of transmitting the disease to the infant by particles of respiratory secretion.
Therefore, breastfeeding should be suspended in the contagious stage and then resumed, or the mother should be provided with a special mask that prevents the spread of Mycobacteria and protects the child.

CMV can be excreted intermittently in human milk. Due to passively transferred maternal antibodies, there is usually no disease in the neonate. However, the risk of symptomatic disease increases in children of seronegative mothers who suffer seroconversion during lactation, and in preterm infants with low concentrations of maternal antibodies acquired transplacentally.

The transmission of the human immunodeficiency virus in breast milk has been demonstrated, mainly in women who acquire it during post-partum period.

Studies indicate that there is no significant increase in the risk of infection in breastfed children by HBsAG positive mothers, especially if immunoglobulin and anti-hepatitis B vaccine are applied.

In relation to the hepatitis C virus, there is a discrepancy regarding its transmission through breast milk. The virus can be present in saliva in up to 36% of carriers. Although a 5% transmission is reported perinatal, RNA has not been isolated in human milk in most studies.

The stimulation of breastfeeding should continue, but it is also essential to support the study of risks and limitations that infectious processes imply for breastfeeding, to be able to properly advise each mother in an individualized way. There is not enough evidence that suggests a new born can get hepatitis through the breast milk.

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• What is Hepatitis C, How Does it Spread and Ways to Prevent Liver Damage in Hepatitis C