Breastfeeding With HIV and Hepatitis

In principle, both HIV and hepatitis viruses can be detected in breast milk. However, the baby’s risk of infection depends on various factors and is different for each pregnant person. However, detecting HIV or hepatitis early can help reduce the risk of your baby getting these diseases. The most important thing is to talk to all your doctors about your condition. In addition, you should look for a paediatrician's practice before the birth and confide in the staff there. This way your child can be well cared for and extensively examined after birth.

You will be offered an HIV test at your first prenatal check-up between the 4th and 8th week of pregnancy. You should definitely take advantage of this offer. In any case, the decision to share the result of the test remains with you. A hepatitis screening usually takes place between the 32nd and 36th week of pregnancy. This examination is obligatory. What to look out for with these diseases when breastfeeding your baby is explained below.

The earlier an HIV infection is detected, the more manageable it is. If you test positive for HIV at the beginning of your pregnancy, you will be referred to a doctor who specialises in HIV. There possible of ways of treating and managing HIV. These should lower the spread of the virus in your body. This means that the amount of virus in your body is reduced to a level that can no longer cause infection in others. After about six months of therapy, the amount of virus in your body may be reduced to the point where it is undetectable by normal tests. If this is the case for six months, then the viral load is considered undetectable. Large studies have shown that then the likelihood of transmission is almost completely eliminated. So if you have been on such a therapy for a long time and if your viral load is undetectable for 6 months, you can breastfeed your baby without the risk of infection. However, you should be supervised the whole time by doctors who specialise in HIV. The most important thing here is to be completely honest with all doctors and to do the treatment as prescribed. The amount of virus in your body should be checked frequently so that any changes can be addressed. If you have been diagnosed with HIV at a late stage, it is important to be open about it. This is the only way to protect your baby from infection.

Your maternity clinic, your midwife and your doctor should definitely be informed about your illness. Then the team can prepare for the birth and take precautions that will lower the possibility of transmission to your baby. You should feed your baby only pre-milk formula (Pre-Milch) until your viral load is low enough. This is how you can protect your baby. Your child will be treated with medication for about 48 hours after birth and for two to four weeks, regardless of your viral load. An HIV test is done after one month and another test after three months. If both tests are negative, your baby is considered HIV negative and healthy.

First, the good news: Hepatitis B and C are not necessarily passed on to the fetus during pregnancy. However, with both hepatitis B and hepatitis C, there is an increased risk of transmission to the baby during birth. This risk increases again if this is a recent infection with lots of the virus in your body. Therefore, treatment is advised if you are known to have hepatitis B during pregnancy. In the case of hepatitis A and B, your baby will be vaccinated after birth and given antibodies called immunoglobulins. These antibodies, combined with the vaccination, have a very high probability of preventing your baby from becoming infected. If the baby has been vaccinated and treated with antibodies, it is possible that you can breastfeed your baby with hepatitis B as well. You should always continue to consult with doctors about this. In principle, there is no risk of hepatitis C transmission through breastfeeding. But in case of nipple injury or inflammation, you should stop breastfeeding and seek medical advice. Hepatitis C treatment during pregnancy is not possible. That's why you should start therapy right after the birth. Unfortunately, breastfeeding your baby is not possible during this therapy. Hepatitis D is a serious infection with hepatitis B. There is no reliable data on transmission through breast milk, but vaccination and administration of antibodies are again the surest protection against transmission to the baby. For hepatitis E and G, there is no evidence of transmission via breast milk.

You can also find good information on the topics of pregnancy with HIV or hepatitis and the therapies available for these diseases on the Aidshilfe website www.aidshilfe.de and at the Early Help Network (Netzwerk Frühe Hilfen) . These counselling centres have been in existence for a long time and have a lot of experience with these issues. Here, your special situation is taken into account and the help is usually free of charge.