title: Should chronic hepatitis B mothers breastfeed? a meta analysis.
abstract: BACKGROUND
  Hepatitis B virus (HBV) exists in the breast milk of chronic hepatitis B (CHB) mothers. The authors use a meta-analytic technique to quantify the evidence of an association between breastfeeding and risk of CHB infection among the infants vaccinated against HBV.
  
  
  METHODS
  Literature search is performed up to 2010 on the relationship between infantile CHB infection within one-year follow up after immunization with the third-dose hepatitis B vaccine and breastfeeding. Two reviewers independently extract the data and evaluate the methodological quality. A random-effects model is employed to systematically combine the results of all included studies.
  
  
  RESULTS
  Based on data from 32 studies, 4.32% (244/5650) of infants born of CHB mothers develop CHB infection. The difference in risk of the infection between breastfed and formula-fed infants (RD) is -0.8%, (95% confidence interval [CI]: -1.6%, 0.1%). Analysis of the data from 16 of the studies finds that RD for mothers who are positive for the HBeAg and/or the HBV DNA, 0.7% (95%CI: -2.0%, 3.5%), is similar to that for those who are negative for these infectivity markers, -0.5% (95%CI: -1.7%, 0.6%).
  
  
  CONCLUSIONS
  Breast milk is infectious; yet, breastfeeding, even by mothers with high infectivity, is not associated with demonstrable risk of infantile CHB infection, provided that the infants have been vaccinated against HBV at birth.
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China. yjzheng@shmu.edu.cn
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Zheng
authors.forename: Yihan
authors.initials: Y
authors.lastname: Lu
authors.forename: Qi
authors.initials: Q
authors.lastname: Ye
authors.forename: Yugang
authors.initials: Y
authors.lastname: Xia
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Zhou
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Yao
authors.forename: Shan
authors.initials: S
authors.lastname: Wei
mesh_terms: D001942:Breast Feeding; D000075202:Contraindications; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000382:microbiology*