Infectious diseases pose a serious health risk for pregnant women and their infants because they are easily transmitted from the mother to the child. This process of passing the virus from mother to baby is called mother-to-child transmission (MTCT) or perinatal transmission. Women infected with a communicable disease must take certain precautions to prevent transmitting it their child. Some women do not experience symptoms of being infected so it vital that the mother is tested for a wide range of communicable diseases as part of her prenatal care—the sooner the mother is diagnosed and treated, the higher the chance the fetus will not become infected.
Each disease requires unique preventative measures but treatment include vaccination for the mother as well as the child. Some MTCT communicable diseases are so prevalent that the World Health Organization (WHO) recommends as part of routine childhood immunizations, such as hepatitis B.
Each disease requires unique preventative measures but treatment include vaccination for the mother as well as the child. Some MTCT communicable diseases are so prevalent that the World Health Organization (WHO) recommends as part of routine childhood immunizations, such as hepatitis B.
Hepatitis B can be spread from mother to child, in utero—mainly during the 3rd trimester, during birth through blood and vaginal fluids and after the baby is born through breastfeeding. The best way to prevent transmission is immunization. The hepatitis B vaccine is 95% effective and essentially eliminates the risk of perinatal transmission including breastfeeding. Because of considerable risk of illness and possible death among infants who are not breastfed, WHO and UNICEF recommend that all infants be exclusively breastfed for at least four months, ideally six months, and that they continue to breastfeed up to two years of age or beyond with the addition of other foods starting at six months of age. There is no evidence that mothers who test positive for Hepatitis B and breastfeed are placing their children at an increased risk of infection. However, because Hepatitis B is transmitted through blood, the Center for Disease Control (CDC) recommends that women with cracked or bleeding nipples, temporarily discontinue nursing.Thus, even where hepatitis B infection is common and immunization is not available, breastfeeding remains the recommended method of infant feeding.
One of the few times breastfeeding is not recommended is when the mother is HIV-positive. HIV/AIDS, is a disease of the human immune system that caused by infection with Human Immunodeficiency Virus. UNICEF acknowledges that mothers who test positive for HIV may pass the virus to their child through breastfeeding. A 2011 article posted on Babywise claims that that there is support for the contraindication of breastfeeding in mothers who test positive for HIV. The article further states that HIV-positive women should refrain from breastfeeding and instead use formula or donor milk as a means of protecting their infant from contracting the HIV virus. This position is not incontrovertible as current WHO recommendations advocate the implementation of Option B/B+ which encourages mothers, in particular those with access to ART therapy, to breastfeed their infants.
It is important to note that HIV/AIDS is also closely linked with another communicable disease; Tuberculosis (TB). Infants who are not known to be HIV-positive should either avoid breastfeeding altogether, or breastfeed with accompanying prophylactic antiretroviral therapy to lower the risk of HIV transmission. Mofenson and Laughon’s research, (2007) confirms that TB is transmitted in utero, through the umbilical vein, by aspiration or ingestion of infected amniotic fluid, through genital secretions during birth or after birth through ingestion of affected breast milk. These infants, born to mothers with TB, are three times more likely to die than infants born to mothers that test negative for TB. The findings recommend transmission prevention measures hinging on testing, diagnosis and treatment. To counteract the detrimental effects of TB, WHO recommends Isaniazad Preventative Therapy (IPT) be administered to infected infants for six months; followed by TB vaccinations. Similar to Hepatitis B, mothers infected with TB are encouraged to breastfeed while undergoing drug-treatment therapy.
MTC of communicable diseases is an important issue worldwide, however, the availability of treatment options and education materials has greatly reduced risk to children.
Written by Stephanie Moore, Fatimah Alfaraj, Stephanie Hedges and Kati Sommer
there is some surprising information in this blog for instance I found it interesting that woman are incourage to breasfeed when undergoing drug treatment theorapy. It makes me wonder if these drugs can harm the baby in any way.
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