Is it safe for a mother infected with hepatitis B virus (HBV) to breastfeed her infant immediately after birth?
Yes. Even before the availability of hepatitis B vaccine, HBV transmission through breastfeeding was not reported. All infants born to HBV-infected mothers should receive hepatitis B immune globulin and the first dose of hepatitis B vaccine within 12 hours of birth. The second dose of vaccine should be given at aged 1–2 months, and the third dose at aged 6 months. The infant should be tested after completion of the vaccine series, at aged 9–18 months (generally at the next well-child visit), to determine if the vaccine worked and the infant is not infected with HBV through exposure to the mother’s blood during the birth process. However, there is no need to delay breastfeeding until the infant is fully immunized. All mothers who breastfeed should take good care of their nipples to avoid cracking and bleeding.

I looked it up. You’re correct and THANK YOU so much for the reference. That really makes it easier for me to verify and clarify!

Another PBR member also pointed it out and gave me an AAP reference ( http://www2.aap.org/breastfeeding/policyOnBreastfeedingAndUseOfHumanMilk.html). You are both correct. The next version of the book will have this correction with Hepatitis B omitted, and also a CMV correction. Here’s the most updated version:

BREAST MILK

Breast milk contains arachidonic acid, DHA, whey, casein, colostrum, hind milk, etc. It’s a lot to remember, so memorize the following and move on!

* ARACHIDONIC ACID (AA) & DOCOSAHEXAENOIC ACID (DHA): Help with neurologic development. Greatest in COLOSTRUM. Not as much in mature milk.

* WHEY: The primary protein in breast MILK.

* CASEIN: The primary protein in FORMULA.

* COLOSTRUM: The milk produced at the end of pregnancy and early after delivery. Only small amounts are expressed in the first few days until the more mature milk finally comes in.

• Yellow color is from carotene.
• Stimulates passage of meconium.
• High in PROTEIN (immunoglobulins, especially IgA).

* HIND MILK: Last bit of milk expressed during breast-feeding. It is highest in CALORIES and FAT.

* FROZEN BREAST MILK: Good for 3-6 months. Once thawed, use within 48 hours.

* CONTRAINDICATIONS TO BREAST-FEEDING: Mother with herpes simplex virus (HSV), HIV, tuberculosis (TB), on chemotherapy, on HYPERthyroid medications, on metronidazole, on sulfa drugs or on Tetracycline. Breast-feeding is also usually contraindicated if the baby has an INBORN ERROR OF METABOLISM. An inverted nipple may be a contraindication depending on the degree of inversion. Breast shells may be needed.

PEARL: Candidiasis, mastitis and fibrocystic disease are NOT contraindications.

PEARL: Breastfeeding is NOT a contraindication for Hepatitis B. For mothers who are CMV carriers (not recent converters), they may also breastfeed.

MNEMONICS: 

• COLOSTRUM: Although it is supplied to babies very EARLY in life, it has tremendous LONG-TERM protective benefits/ingredients (AA, DHA, IG’s/IgA aka protein).
• MATURE MILK is the regular, everyday milk that provides the regular, everyday ingredients to a baby (fat, lactose, “energy,” etc.).
• HIND MILK: HIND milk has a high FAT and CALORIC content, like the unusually oversized beHIND of an appropriately overweight/fat new mom. (Sorry for the un-PC mnemonic. Hopefully it helps).
• WHEY: A BREAST full of milk WEIGHS much more than in a can of powdered formula.

Breastmilk is WHEY better, and formula comes in a Case (or if you speak Yoda…”Case-in formula comes”)