"Dr. Rob,
This is exact response of Dr. Ryan to the Hep B question:
Because the hep B virus (HBV) is shed in breast milk, Dr. Mishell
believes that it may cause infection, as has occurred with other viruses,
such as HIV. The evidence in the medical literature, however, seems to be
to
the contrary. Infants born to
HbsAg-positive mothers should receive Hep B immune globulin and hepatitis B
vaccine immediately after birth, but breast-feeding poses no additional risk
for acquisition of HBV infection. To date, HBV transmission through
breast-feeding has not been documented, but there is some controversy.
Certainly, mothers in developing countries where formula is not available
should breast-feed. In the United States, a mother who strongly desires to
breast-feed her infant can probably do so with minimal or no risk.
Therefore, the recommendations of the AAP (as presented in the 1997 Redbook)
that breast-feeding is safe for these infants and poses no additional risk
for HBV infection are legitimate.
He was doing fine until the sentence that begins with "certainly " and "And
in the U.S." It seems he still has some doubt. And mothers in developing
countries need to BF not because of formula availability but because the
child is MUCH more likely to die from diarrhea. I know you know this but I
want to make sure you are seeing my line of thought. Lastly, even in the
U.S. what about the risks of artificial feeding? Compare that to the risk
Dr. Ryan seems to feel just might still be there.
Chris B. "
Chris,
I think Dr Ryan my have been trying to be a bit diplomatic as he along with
readers were saying to Dr Mischell "you are wrong"
I can pass the concerns on to Dr Ryan.
-Rob
Rob Cordes, DO, FAAP, FACOP
Wilkes Barre PA
mailto:[log in to unmask]
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