Which is not a C/I for breast feeding?: (A) Intake of tetracycline, (B) Puerperial mastitis, (C) Intake of lithium carbonate, (D) Active hepatitis B Infection
Answer is D. Ans: d (Active hepatitis B infection)Ref: William's Obstetrics, 23rd ed., ACOG GuidelinesBreast feeding is recommended by all the nursing mothers immediately in about 30 min post delivery in cases of a normal delivery and usually within 4 hours in cases of a cesarean section unless some obvious contra-indication exists.Breast milk provides all the necessary nutrients that are needed for the growth and adequate development of a baby for the initial 6 months. Hence exclusive breast feeding is recommended.The first secretions on the initial 2-3 days is called as "colostrum" and it contains a very high quantity of immunoglobulins and hence it is recommended to commence breast feeding as early as possible.Active hepatitis B infection is not a contraindication for breast feeding provided the infant has received the anti-HbsAg immunoglobulins and would be vaccinated soon.The immunoglobulins offer significant protection against the virus. Similarly, even active HCV infection is not a contraindication for breast feeding as the risk of viral transfer for HCV is only 4%.Listed contra-indications are: Active TB infectionPatient on treatment for breast cancer Patient taking uncontrolled levels of alcohol Patients on certain drugs Patients having active HIV