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Thread: Hepatitis C positive mom new to breastfeeding.

  1. #1

    Default Hepatitis C positive mom new to breastfeeding.

    Dear all,

    I am a second time mom (daughter born 3/28/12) and I am Hepatitis C positive. I was infected when I was a child through a blood transfusion.

    Due to many different reasons I won't go into here, I bottle fed my first child. For my second child, I consulted with a Hep C specialist & a perinatal specialist and they said that it would be ok to breastfeed. I breastfed the first few days of my daughter's life. It was such a wonderful experience. Last night, my daughter went on a 4+ hour nursing marathon. This morning I found small scabs on both of my nipples. Since then, I have stopped nursing and have been giving her formula.

    I'm so sad and disappointed to the point where I've had a few crying jags. My daughter was confused at first with the bottle nipple. I can tell she wants to breastfeed and I also miss the closeness with her. It was so satisfying to breastfeed.

    I have been "pumping and dumping". I'm trying to pump several times a day to get my milk supply up. After my scabs heal, I will try again. But I don't know if that much nipple soreness is common? Will I get it again? Will I have to stop again and pump and dump? Should I not attempt to breastfeed and just give her breastmilk from a bottle once I am healed up?

  2. #2
    Join Date
    Feb 2012
    Location
    middle of IA
    Posts
    1,885

    Default Re: Hepatitis C positive mom new to breastfeeding.

    Im sorry about the scabs... There are other posts on here about how to heal them, hopefully someone will post that here for you.

    But No! Don't start exclusive pumping if you can help it. Let's get her back to the breast.

    You don't really say that your nipples hurt - do they? Is that why you're pumping? Does pumping hurt less than nursing? How old is your baby? Has anyone looked at her latch?

    Also why pump & dump? Is there a reason you can't freeze that milk? I sure would.
    DS1 6/7/11
    DS2 10/29/13

    Nursing, pumping, cloth-diapering, babywearing, working professor mama with the awesomest SAHD ever.

  3. #3
    Join Date
    Mar 2011
    Location
    MA
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    Default Re: Hepatitis C positive mom new to breastfeeding.

    There is no reason you can't continue to nurse, but you want to get any latch issues worked out so that you can try to prevent having to deal with this again. If you do have these issues again, try not to feel bad. It's not your fault. You're trying to do what's best for your baby. We all get emotional about it, though. From what I've read I know that you shouldn't be breastfeeding if your nipples are cracked or bleeding.. I don't know about scabbing, honestly. I would talk to a doctor or lactation consultant who has experience with Hepatitis C. Don't give up, this might be a little bit harder, but not impossible and it is definitely worth it.

  4. #4
    Join Date
    Jun 2006
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    COUGARTOWN Baby! From here on in!
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    Default Re: Hepatitis C positive mom new to breastfeeding.

    Why did you dump the milk you pumped???

    Way too lazy for formula

  5. #5
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    Default Re: Hepatitis C positive mom new to breastfeeding.

    She's worried about blood being in the milk, probably

  6. #6
    Join Date
    Jun 2009
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    Default Re: Hepatitis C positive mom new to breastfeeding.

    Mothers with Hep C usually certainly can breastfeed, the evidence suggests that the disease is NOT transmitted via breastfeeding.

    Nipple soreness is VERY common, (EDIT: most usual in the very early days as mom and baby figure out positioning and latch.) So is nipple injury and traces of blood in breastmilk. Blood ingestion by baby from this is not a normally any concern, I assume it is only a concern to you due to your Hep C status.

    I assume you are concerned about the scabbing & your milk because you are concerned that your baby is ingesting your blood from the nipple injury. I see that the CDC does recommend pumping and dumping for Hep C positive moms when nipples are cracked and bleeding, until the nipples heal. But they also say that there is no evidence either way if this is necessary or not. It is a precautionary suggestion.


    Your nipples should heal very quickly as long as they are not being reinjured. See info on here and on www.kellymom.com for healing sore nipples tips, but since they are scabbing already that suggests healing has begun. So it won't be long at all before you can start nursing at the breast again. meanwhile, snuggle, cuddle, treasure and love your baby. You guys need each other! I know it's hard to see baby wanting to nurse when you can't, but if baby keeps trying to nurse, that is very good, as it suggests she will go back to the breast easily once you can.

    Scabbing and nipple pain usually means a not-quite-there latch. There is so much you can do to work on that, either on your own or with a IBCLC or other breastfeeding helper. Latch issues are common, are almost always solvable, and there is a very good chance you can go on to nurse happily for as long as you and baby wish. Breastfeeding is worth fighting for!

    If you intend to pump and dump until you heal, make sure you are using as good a pump as you can afford, (hospital grde rental being the best) that you pump regularly (10 X a day if you can) and make very sure that the pump is not reinjuring you!!! You can hand express as well. See http://www.llli.org/docs/00000000000...expression.pdf

    Also feed baby in as breastfeeding a supportive way possible. See http://www.llli.org/docs/00000000000...astfedbaby.pdf and let me know if you would like info on other alternative feeding methods like cup feeding.

    Meanwhile, find some names for good, experienced, highly recommended IBCLC's or LC's in your area. Often latch issues can be worked out by moms and babies on their own, but because in your case you do not want to risk re-injury, you may want to go right to getting professional help with latch if you can rather than trying to work this out all on your own. Call & chat with at least 2-3 of these IBCLC's or LC's and make sure you find one you think you will feel most comfortable with and confident in. For names see www.ilca.org but I also suggest geting names from your local LLL Leaders, doctors, breastfeeding friends, etc.

    Thomas Hale has a book called "Clinical Therapies in Breastfeeding Patients." I just was reading about Hep C in it yesterday, unfortunately it was not my copy and I don't have it, but the studies are interesting and I think it would be great if you could read the info for yourself or talk to an expert more in depth about risk factors. An LC may (should) have this book? Or, try calling the folks at infantrisk. This is Hale's own helpline, for medication questions primarily but I bet you can ask them about hep c as well. (?) Can't hurt to call, they are only open weekdays, central time. See www.infantrisk.com for phone number.

    EDIT: The lactation textbook Breastfeeding Answers Made Simple (Mohrbacher, 2010) discusses the issue of Hep C positive mom nursing with cracked and bleeding nipples. Basically the recommendation to discontinue nursing at the breast and to pump and dump until nipples heal is a controversial one, with some medical professionals arguing that this is an unnecessary precaution. Again, this is a book a local LC would likely have and could read the info to you, just so you have all the relevant info.
    Last edited by @llli*lllmeg; April 1st, 2012 at 02:01 PM. Reason: added last paragraph & clarified that nipple soreness/injury is most common early on as mom and baby work on latch/position

  7. #7

    Default Re: Hepatitis C positive mom new to breastfeeding.

    Thank you all for the information, advice and encouragement. I will contact the lactation consultant at the hospital today. They aren't on call during the weekends.

    It hurts for a moment during the initial latch. I have been grazing her lips with my nipple to get her to open wide and adjusting her bottom lip. I put her on a pillow and hold her in a plank position, on her side with her head facing me. Have been using lanolin on my nipples...looking at the www.kellymom.com website I see that I probably had a milk blister on my nipple. The left has healed, the right is worse off so I am pumping exclusively from that one.

    I got a Medela Pump in Style backpack and it is working out great. It's difficult to make time in my schedule to pump 10x...I am trying to pump as much as I can!

  8. #8
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    Default Re: Hepatitis C positive mom new to breastfeeding.

    I got a Medela Pump in Style backpack and it is working out great. It's difficult to make time in my schedule to pump 10x...I am trying to pump as much as I can!
    For short term round the clock pumping, as this will presumably be, the P&S may well be fine. Yes it is difficult to pump 10 times a day, so do what you can, this is how often (at a bare minimum) your newborn would be nursing and you are trying to replicate that as closely as possible. Your baby is less than a week old, right? So this time is vital for building an appropriate milk supply for the duration. This is very much new baby crunch time even when everything is going perfectly, so I hope you have lots of help at home to assist with care for your older child, make meals, etc.

    If it makes it easier, there is no need to pump on a strict "every such and such hour" schedule. A newborn would not normally be nursing on such a schedule so no reason to pump that way. See: http://www.llli.org/docs/00000000000...umpigchart.pdf

    Please make sure the LC at your hospital (or whoever she recommends) is educated and clinically trained in assisting mothers one on one with latch issues. And a lactation consultant appointment should usually last about 90 minutes. I just mention this because some hospitals will hire nurses or other individuals with little or no experience/education in lactation assistance and cal them "Lactation Consultants" or "Lactation Nurses." Also unfortunately, some hospitals will have well trained and experienced LCs on staff but do not allow them the time needed to properly assist moms. Hint: If she has the letters IBCLC after her name, you know she is board certified. An LC does not have to be board certified to be good but it's a quick way of knowing they at least have a certain amount of lactation education/clinical experience.

    You might want to consider different positions, with and without a nursing pillow, pillows work great in some circumstances but for some moms & babies they create positions that puts stress on the nipples. Latch and positioing is very individual, there is no one right way to nurse a baby. For example "Laid back" positions often help with owie latch issues. for more see: http://www.llli.org/docs/00000000000...astfeeding.pdf and http://www.biologicalnurturing.com/

  9. #9

    Default Re: Hepatitis C positive mom new to breastfeeding.

    Hi all,

    I wanted to give an update in case there are other Hep C positive moms/moms to be out there. My daughter is about ten months old now. I didn't give up breastfeeding and I haven't had any problems since the nipple scabs except for one case of mastitis. I work and pump during the day. Her bottles are supplemented with formula as I am pumping about 4 oz. a day. She was tested at 6 months for Hep C and tested negative for the virus, but positive for the antibodies. The doctor explained that the antibodies are passed through the breastmilk. This does not mean she has the virus. They will test again at 18 months.

  10. #10
    Join Date
    Jun 2009
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    5,611

    Default Re: Hepatitis C positive mom new to breastfeeding.

    Thank you so much for the update janzed! I am so happy to hear you are still nursing your dear baby.

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