Avem urmatoarele detalii: Andreea, viitoare mamica cu bebelina nr 2 urmeaza a naste prin cezariana pe

6 ian (motivul cezarienii fiind cezariana si la bebe nr 1). In timpul analizelor din timpul nasterii a fost
descoperita ca fiind purtatoare a virusului hepatitei C. Deoarece pe primul bb nu l a alaptat, isi doreste
foarte mult alaptarea celui de al doilea. insa doctorii i au spus ca nu i se recomanda alaptarea. A fost si la
boli infectioase, la Matei Bals, iar o doamna doctor de acolo i a spus ca poate alapta atata timp cat mu
face ragade. Intr adevar, dintr o simpla documentare a mea pe tema hepatitei C, am ajuns la concluzia
ca hepatita C nu este un motiv de a nu alapta. Trebuie doar avut grija la ragade si atat.

Mai jos avem cateva articole traduse de mine pe aceasta tema:

Hepatitis C Virus Infection
Is it safe for a mother infected with hepatitis C virus (HCV) to breastfeed her infant?
Yes. There is no documented evidence that breastfeeding spreads HCV. Therefore, having HCV-
infection is not a contraindication to breastfeed. HCV is transmitted by infected blood, not by human
breast milk. There are no current data to suggest that HCV is transmitted by human breast milk.
Is it safe for the HCV-positive mother to breastfeed if her nipples are cracked and bleeding?
Data are insufficient to say yes or no. However, HCV is spread by infected blood. Therefore, if the HCV-
positive mother's nipples and/or surrounding areola are cracked and bleeding, she should stop nursing
temporarily. Instead, she should consider expressing and discarding her breast milk until her nipples
are healed. Once her breasts are no longer cracked or bleeding, the HCV-positive mother
breastfeeding.
Reference: CDC. Recommendations for prevention and control of Hepatitis C virus (HCV) infection and
HCV-related chronic disease. MMWR, October 16, 1998, 47(RR-19):139.
source: Centers for Disease Control and Prevention - USA
http://www.cdc.gov/breastfeeding/disease/hepatitis.htm
Infectia cu virusul Hepatitei C
Este sigur ca o mama infectata cu virusul Hepatitei C (HCV) sa-si alapteze bebelusul?
Da. Nu exista nici o sursa de informatii documentate ca alaptarea transmite HCV. Totusi, avand infectia
cu HCV nu este o contraindicatie de a alapta. HCV se transmite prin sange infestat, nu prin laptele de
mama. Nu exista nici o data curenta care sa sugereze ca HCV este transmis prin laptele de mama.

Este sigur ca o mama positica cu HCV sa alapteze daca mameloanele sunt crapate sau sangerande?
Datele sunt insufieciente pentru a spune da sau nu. Totusi, HCV este transmis prin sange infestat. Prin
urmare, daca mameloanele mamei infectate si/sau zona din preajma areolei sunt crapate sau
sangerande, ea ar trebui sa opreasca alaptarea temporar. In schimb, ea ar trebui sa arunce laptele muls
pana cand mameloanele sunt vindecate. O data ce sanii nu mai sunt crapati sau sangeranzi, mama cu
HCV poate relua complet alaptarea.

Hepatitis C is not spread through breast milk, food or water or by casual contact such as hugging,
kissing and sharing food or drinks with an infected person.
source: World Health Organization - http://www.who.int/mediacentre/factsheets/fs164/en/
Hepatita C nu se transmite prin laptele de mama, mancare sau apa sau prin atingeri, cum ar fi
imbratisatul, sarutatul or impartirea de mancare sau bautura cu persoane infectate .

Hepatitis C Virus (HCV)
Hepatitis C is characterized by mild or asymptomatic infection with insidious onset of jaundice and
malaise. In some cases, the course is remittent. An average of 50% of the patients develop chronic
liver disease, including cirrhosis. Hepatocellular carcinoma may be associated with Hepatitis C as well
as chronic Hepatitis B infections. Hepatitis C virus (HCV) occurs worldwide and has several modes of
transmission.
It is well recognized that HCV can be transmitted by contact with blood or blood products through
transfusions, intravenous drug use, sexual contact and needle, stick exposure.
The risk of perinatal transmission is approximately 4 % although reported rates of transmission vary
depending on virus genotype, coinfection with HIV and HCV, RNA antigen titers. Overall, the risk of
perinatal transmission of HCV appears extremely low if mother is HCV, antibody positive but HCV-PCR
(antigen) negative at the time of delivery. Several recent studies demonstrate no increased risk of
transmission attributable to breastfeeding. All major health organizations (i.e. World Health
Organization, Centers for Disease Control, National Institutes of Health and American Academy of
Pediatrics) recommend or support breastfeeding by Hepatitis C carrier mothers. As the risk of vertical
tranmission of HCV appears to increase with HCV-RNA titer, one approach would be to breastfeed if
the mothers HCV PCR is negative or low titer, and recheck the mothers titer periodically. HCV
antibodies and HCV-PCR should be followed periodically in the infant during the first 12 to 18 months
of life whether or not the infant is breastfed.
sursa: Breastfeeding Coalition
http://www.breastfeeding.org/uploaded_files/newsletters/newsletter4.PDF
Virusul Hepatitei C
Hepatita C se caracterizeaza printr-o infectie usoara sau asimptomatica cu debut de icter sau stare de
rau. In unele cazuri, cursul bolii poate fi intermitent. O medie de 50% a pacientilor dezvolta boli cornice
de ficat, inclusiv ciroza. carcinomul hepatocelular poate fi asociat cu hepatita C la fel de bine ca si o
infectie cu hepatita B. Virusul Hepatitei C (HCV) se intampla peste tot in lume si are mai multe moduri de
transmitere.
Este bine cunoscut ca HCV poate fi transmis prin contactul cu sange sau recipiente de sange ce se
folosesc in timplu transfuziilor, prin droguri injectate intravenos, contact sexual, prin ac infectat.
Riscul transmiterii perinatale este de ~ 4%, desi ratele raportate de transmitere variaza in functie de
genotipul virusului, coinfectie cu HIV si VHC, titruri de antigen ARN. In general, riscul de transmitere
perinatala a VHC pare extrem de scazuta in cazul in care mama este VHC, anticorpi pozitiv, dar HCV-PCR
(antigen) negativ la momentul nasterii. Cateva studii recente demonstreaza ca nu exista un risc crescut
de transmitere atribuita alaptarii. Toate organizatiile importante de sanatate (de ex Organizatia
Mondiala a Sanatatii, Centru de Preventie si contraol al Bolilor, Institutelele Nationale de Sanatatee si
Academia Americana de Pediatrie) recomanda si incurajeaza alaptarea mamelor purtatoare de Hepatita
C. Deoarece riscul de tranmismitere verticala a HCV pare sa creasca cu ARN-VHC titru, o abordare ar fi sa
alapteze, daca in cazul mamei VHC-PCR este negativ sau titru scazut, si verificati din nou periodic titru
mamei. Anticorpii VHC si VHC-PCR ar trebui sa fie verificati periodic la copil in primele 12-18 luni de viata
chiar daca copilul este la alaptat la san sau nu.