In the United States, breastfeeding is currently contraindicated if the mother is HIV-positive to reduce the risk of postnatal transmission of the virus to the infant. Except for HIV and human T-cell leukemia virus type 1 (HTLV-1), no other infections are an absolute contraindication to breastfeeding in the United States. There is no evidence that hepatitis B is transmitted in breast milk or by breastfeeding. In infants of mothers who are positive for hepatitis B surface antigen, the initiation of breastfeeding can begin after delivery without waiting for hepatitis B immunoglobulin or the vaccine to be given. Hepatitis B immune globulin should be given within the first 12 hours after birth, and the vaccine should be administered before discharge from the hospital.
1. Committee on Nutrition, American Academy of Pediatrics. Pediatric nutrition handbook. 4th ed. Elk Grove Village (IL): American Academy of Pediatrics; 1998.
2. Lawrence RA, Lawrence RM. Breastfeeding: a guide for the medical profession. 5th ed. St. Louis (MO): Mosby; 1999.
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