Women living with chronic hepatitis B virus (HBV) infection can safely breast-feed their infants after birth, providing that a few precautions are followed, according to a study published in the Archives of Pediatrics & Adolescent Medicine and reported by Reuters Health.

Hepatitis B infection causes swelling and inflammation of the liver and can lead to permanent liver damage. As the hepatitis B virus-usually transmitted through blood, sex and unclean needles-is found in blood and both amniotic and vaginal fluids, it can be passed from mother to child during pregnancy or labor. Whether the virus could be passed along through breastfeeding is another matter.

In an effort to explore this topic, scientists compiled data from 10 other studies performed in China, which included more than 1,000 babies whose mothers had hepatitis B. About half of the babies were breast-fed by their mothers. The babies in the study received a hepatitis B vaccine and another injected medication soon after birth, followed by two or three more vaccinations over the next months.

The researchers found that one year after birth, 31 of the 637 breast-fed babies in the study tested positive for hepatitis B. Of the 706 non-breast-fed babies in the study, 33 tested positive. However, most of the infections in both cases resulted from pregnancy or childbirth.

“Breast feeding should be recommended as a valuable source of nutrition to infants,” said lead author Zhongjie Shi, MD, of Temple University in Philadelphia. The authors added that mothers should refrain from breast feeding if they have cracked or bleeding nipples, as blood is the primary means by which the hepatitis B virus is passed from mother to child.