Expert consensus on breastfeeding in case of maternal infections

Human breast milk is the best food for infants. However, maternal infection may result in cessation of breastfeeding, because of concerns on mother-to-child transmission(MTCT) of pathogens, even in the absence of relevant evidence. Based on the progress on MTCT, Chinese experts group on perinatal medicine developed the following consensus on maternal infections and breastfeeding: (1) Mothers infected with hepatitis viruses, including hepatitis A, B, C, and E, are recommended to breastfeed their infants;(2) When mothers are positive for cytomegalovirus IgG, for full-term or late preterm infants (gestational age≥32 weeks at birth or birth weight ≥1 500 g), breastfeeding is recommended, but for early preterm infants (gestational age <32 weeks at birth or birth weight <1 500 g), sterilized breast milk is recommended first and then breastfeeding when corrected gestational age ≥32 weeks or ≥1 500 g;(3) Mothers infected with viruses in Herpes viridae, except for infection on breast, can directly breastfeed their infants;(4) Infants born to mothers with influenza virus or SARS-CoV-2 can be fed with expressed breast milk with no requirement for sterilization;(5) Infants of HIV-infected mothers are recommended to receive exclusive formula feeding whenever possible, while mixed feeding is contraindicated;(6) When mothers are infected with tuberculosis, Treponema Pallidum, Leptospira, Toxoplasma Gondii or Plasmodium, infants can receive pasteurized breast milk before and during pathogen-specific treatment and switch to direct breastfeeding after standard treatment;(7) None of the inactivated or attenuated live vaccines inoculation for lactating women can cause adverse effects for their infants, except yellow fever live vaccine which may cause infant infection via breastfeeding;(8) Infants can receive vaccination whilst breastfeeding;(9) Although pasteurization can partially damage some bioactive components and nutrients in breast milk, pasteurized breast milk is still more beneficial for the offspring than formula. Copyright © 2021 by the Chinese Medical Association.