Hi, Susan, in answer to your request for references to support
breastfeeding when mama is HCV positive:

The National Institute of Health issued a statement in March 1997 about
Hepatitis C management, and said this about breastfeeding by Hepatitis
C-infected mothers:  "Pregnancy is not contraindicated in HCV-infected
individuals. Perinatal transmission from mother to baby occurs in less
than 6 percent of instances. There is no evidence that breast-feeding
transmits HCV from mother to baby; therefore, it is considered safe.
Babies born to HCV-positive mothers should be tested for anti-HCV at 1
year."

You can find this statement at:
http://www.hepnet.com/nihstate.html

With this advice about how to reference it:  "This statement will be
published as: Management of Hepatitis C. NIH Consensus Statement 1997
March 24-26;15(3): in press. For making bibliographic reference to
consensus statement no. 105 in the electronic form displayed here, it is
recommended that the following format be used: NIH Consensus Statement
Online 1997 March 24-26 [cited year, month, day]; 15(3): in press."

Two other good references are:

Fischler B, Lindh G, Lindgren S et al.  Vertical transmission of hepatitis
C virus infection.  Scandinavian Journal of Infectious Diseases, 1996
28(4):353-356.  "The risk of vertical transmission is low and
breastfeeding is safe."

Lin H-H, Kao J-H, Hsu H-Y et al.  Absence of infection in breast-fed
infants born to hepatitis C virus-infected mothers.  Journal of
Pediatrics, April 1995 126(4):589-591.  "No breastfed infant had evidence
of HCV infection for up to 1 year of age."

Ginna Wall, MN, IBCLC, Lactation Services Coordinator
University of Washington Medical Center, Mailbox 356153
1959 NE Pacific Street, Seattle WA 98195
Voicemail: (206)548-6368, Fax: (206)548-7665