OBJECTIVETo explore the safety testing evaluation index of breast-feeding by hepatitis B-positive mothers.

METHODSHBV DNA from serum and breast milk of 252 hepatitis B-positive mothers were detected with the real-time quantitative PCR.

RESULTSThe total positive rate of HBV DNA in serum had no difference with that in breast milk in hepatitis B-positive mothers (P > 0.05). The positive rate of HBV DNA in serum and breast milk of positive HBeAg were significantly higher than that of hepatitis B-positive mothers with negative HBeAg (P < 0.01).

CONCLUSIONTo detecte HBeAg and HBV DNA in serum and breast milk have important significance for guiding of breast feeding of hepatitis B-positive mothers.

Adult ; Breast Feeding ; DNA, Viral ; analysis ; Female ; Hepatitis B ; virology ; Hepatitis B e Antigens ; analysis ; Humans ; Milk, Human ; virology ; Pregnancy ; Pregnancy Complications, Infectious ; virology

OBJECTIVETo quantify human cytomegalovirus (HCMV) DNA in the blood and urine of infants of different ages with suspected HCMV infection, and in the breast milk of their mothers, and to evaluate the significance of HCMV DNA detection in the three specimen types in the diagnosis of HCMV infection among infants of different ages.

METHODSA total of 170 infants with suspected HCMV infection were divided into groups A (<28 days; n=43) and B (28 days to 5 months; n=127) according to their ages. Blood and urine were collected from the infants, and breast milk was collected from their mothers. The specimens were examined by fluorescence quantitative PCR for detection of HCMV DNA.

RESULTSIn group A, HCMV DNA detection rates in blood, urine and breast milk were 65.1%, 18.6% and 93.0% respectively. In group B, HCMV DNA detection rates in blood, urine and breast milk were 64.6%, 92.9% and 72.4% respectively. HCMV DNA detection rate in urine in group B was significantly higher than in group A (P<0.01), however, HCMV DNA detection rate in mothers' breast milk in group B was significantly lower than in group A (P<0.01). Among the 82 infants with positive results for blood and urine, the copy number of HCMV DNA in urine was significantly higher than that in blood.

CONCLUSIONSHCMV DNA detection rates in urine and breast milk are different among infants of different ages, so use of suitable specimens according to age is of great significance for improving detection rate.

Animals ; Cytomegalovirus Infections ; diagnosis ; DNA, Viral ; analysis ; blood ; urine ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Milk, Human ; virology ; Pregnancy

OBJECTIVETo investigate the relationship between pre-core G1896A point mutation of hepatitis B virus (HBV) and safety of breast feeding.

METHODSSerum and breast milk samples were collected from 62 pregnant women of HBV DNA positive/HBeAg negative. PCR-solid phase hybridization was used to detect the point mutation in pre-core region G1896A of HBV from pregnant women, and HBV DNA loads in sera and breast milk were determined by fluorescence quantitative PCR (FQ-PCR).

RESULTSThe prevalence of point mutation was 61.3% (38/62) in 62 pregnant women with HBsAg positive/HBeAg negative. The positive rate of HBV DNA in breast milk of group with point mutation (28.9%) was similar to that of group without mutation (29.2%, chi2=0.0003, P>0.05). However, The positive rate of HBV DNA in breast milk of group with high HBV loads (56.0%) was significantly higher than that of group with low HBV loads (10.8%, chi2=14.79, P<0.01).

CONCLUSIONThe point mutation in pre-core region G1896A of HBV dose not affect the positive rate of HBV DNA in breast milk and higher HBV DNA loads in serum of pregnant women might increase the risk of mother-infant transmission.

Breast Feeding ; DNA, Viral ; blood ; Female ; Hepatitis B ; transmission ; Hepatitis B virus ; genetics ; Humans ; Milk, Human ; virology ; Point Mutation ; Pregnancy

Breast milk is considered ideal food for premature infants, but it can also be the main source of cytomegalovirus (CMV) infection in premature infants. CMV infection may cause serious clinical symptoms, such as sepsis-like syndrome, thrombocytopenia, neutropenia, jaundice, hepatitis, and pneumonitis. This article reviews the research advances in symptoms, treatment strategies, prognosis and the prevention of breast milk-acquired CMV infection in premature infants.
Breast Feeding ; Cytomegalovirus Infections ; etiology ; prevention & control ; therapy ; Humans ; Infant, Newborn ; Infant, Premature ; Infectious Disease Transmission, Vertical ; prevention & control ; Milk, Human ; virology

The recently emerged novel coronavirus pneumonia, named the coronavirus disease 2019 (COVID-19), shares several clinical characteristics with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and spread rapidly throughout China in December of 2019 (Huang et al., 2020). The pathogen 2019 novel coronavirus (2019-nCoV) is now named SARS coronavirus 2 (SARS-CoV-2) and is highly infectious. As of Apr. 9, 2020, over 80 000 confirmed cases had been reported, with an estimated mortality rate of 4.0% (Chinese Center for Disease Control and Prevention, 2020). Person-to-person transmission and familial clustering have been reported (Chan et al., 2020; Nishiura et al., 2020; Phan et al., 2020). However, there is no evidence of fetal intrauterine infection in pregnant women who have been infected with SARS-CoV-2 in their third trimester (Chen et al., 2020). It is unclear whether breastfeeding transmits the virus from previously infected and recovered mothers to their babies. Here we report the clinical course of a pregnant woman with COVID-19. In order to determine whether SARS-CoV-2 can be transmitted to newborns through breastfeeding, we measured viral RNA in the patient's breastmilk samples at different time points after delivery.
Adult ; Betacoronavirus ; Breast Feeding ; China ; Coronavirus Infections ; diagnosis ; Female ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Milk, Human ; virology ; Pandemics ; Pneumonia, Viral ; diagnosis ; Pregnancy ; Pregnancy Complications, Infectious ; virology ; RNA, Viral ; isolation & purification

OBJECTIVETo study the instructional significance of HBV-DNA load in maternal milk on breastfeeding of postpartum women infected with HBV.

METHODSHBV-DNA levels in serum and breast milk were detected by FQ-PCR in 152 postpartum women infected with HBV, and HBV-DNA ≥ 1.0 × 10(3) U/ml was defined as HBV positive. Correlation analysis was also conducted to estimate if there were relations in HBV levels in serum and breast milk.

RESULTSHBV-DNA positive rate were 50.66% (77/152) and 36.18% (55/152) in serum and breast milk, respectively. When HBeAg was positive, HBV-DNA positive rate were 95.38% (62/65) and 76.92% (50/65) in serum and breast milk; however when HBeAg was negative, HBV-DNA positive rate were 17.24% (15/87) and 5.75% (5/87) in serum and breast milk. When the concentration of HBV-DNA was 3-4 lg U/ml in serum, HBV-DNA positive rate was 20.00% (5/25) in breast milk; However, when the concentration of HBV-DNA was higher than 5 lg U/ml in serum, HBV-DNA positive rate was 96.15% (50/52) in breast milk.

CONCLUSIONThe HBV-DNA level in breast milk in postpartum women infected with HBV increased with the HBV-DNA levels in serum. Breastfeeding should be avoided when the concentration of HBV-DNA is higher than 1.0 × 10(3) U/ml in milk.

Adult ; Breast Feeding ; DNA, Viral ; isolation & purification ; Female ; Hepatitis B ; prevention & control ; transmission ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Milk, Human ; virology ; Viral Load ; Young Adult

PURPOSE: Extremely low birth weight infants (ELBWIs) have a high risk of acquiring cytomegalovirus (CMV) infection via breast milk and consequently developing serious symptoms. We evaluated whether freeze-thawing or pasteurization could prevent postnatal CMV infection transmitted through breast milk in ELBWIs. MATERIALS AND METHODS: Medical records of 385 ELBWIs with whole milk feeding, and freeze-thawed or pasteurized breast milk feeding were reviewed retrospectively. Postnatally acquired CMV infection was defined as an initial negative and a subsequent positive on follow-up urine CMV DNA polymerase chain reaction screening tests. The incidence, clinical characteristics, symptoms, sequelae, and long-term outcome at corrected age [(CA): 2 years of CMV infection] were analyzed. RESULTS: While no infant developed CMV infection with whole milk (0/22) or pasteurized breast milk (0/62) feeding, postnatal CMV infection was diagnosed in 8% (27/301) of ELBWIs who were fed freeze-thawed breast milk. Gestational age in the CMV group was significantly lower than the control group. In 82% (22/27) of cases, CMV infection was symptomatic and was associated with increased ventilator days and > or =moderate bronchopulmonary dysplasia (BPD). Neurodevelopmental outcome and growth status at CA 2 years were not different between the study groups. Lower gestational age and freeze-thawed breast milk feeding >60% of total oral intake during the first 8 postnatal weeks were independent risk factors for acquiring postnatal CMV infection. BPD (> or =moderate) was the only significant adverse outcome associated with this CMV infection. CONCLUSION: Pasteurization but not freeze-thawing of breast milk eradicated the postnatal acquisition of CMV infection through breast milk.
Adult ; Breast Feeding ; Bronchopulmonary Dysplasia ; Cytomegalovirus/*isolation & purification ; Cytomegalovirus Infections/epidemiology/prevention & control/*transmission ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; *Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infectious Disease Transmission, Vertical/*prevention & control ; Male ; Milk, Human/chemistry/*virology ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Retrospective Studies ; Risk Factors

INTRODUCTION: Pregnant women are reported to be at increased risk of severe coronavirus disease 2019 (COVID-19) due to underlying immunosuppression during pregnancy. However, the clinical course of COVID-19 in pregnancy and risk of vertical and horizontal transmission remain relatively unknown. We aim to describe and evaluate outcomes in pregnant women with COVID-19 in Singapore. METHODS: Prospective observational study of 16 pregnant patients admitted for COVID-19 to 4 tertiary hospitals in Singapore. Outcomes included severe disease, pregnancy loss, and vertical and horizontal transmission. RESULTS: Of the 16 patients, 37.5%, 43.8% and 18.7% were infected in the first, second and third trimesters, respectively. Two gravidas aged ≥35 years (12.5%) developed severe pneumonia; one patient (body mass index 32.9kg/m2) required transfer to intensive care. The median duration of acute infection was 19 days; one patient remained reverse transcription polymerase chain reaction (RT-PCR) positive >11 weeks from diagnosis. There were no maternal mortalities. Five pregnancies produced term live-births while 2 spontaneous miscarriages occurred at 11 and 23 weeks. RT-PCR of breast milk and maternal and neonatal samples taken at birth were negative; placenta and cord histology showed non-specific inflammation; and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immunoglobulins were elevated in paired maternal and umbilical cord blood (n=5). CONCLUSION The majority of COVID-19 infected pregnant women had mild disease and only 2 women with risk factors (obesity, older age) had severe infection; this represents a slightly higher incidence than observed in age-matched non-pregnant women. Among the women who delivered, there was no definitive evidence of mother-to-child transmission via breast milk or placenta.
Abortion, Spontaneous/epidemiology* ; Adult ; COVID-19/transmission* ; COVID-19 Nucleic Acid Testing ; COVID-19 Serological Testing ; Cohort Studies ; Disease Transmission, Infectious/statistics & numerical data* ; Female ; Fetal Blood/immunology* ; Humans ; Infectious Disease Transmission, Vertical/statistics & numerical data* ; Live Birth/epidemiology* ; Maternal Age ; Milk, Human/virology* ; Obesity, Maternal/epidemiology* ; Placenta/pathology* ; Pregnancy ; Pregnancy Complications, Infectious/physiopathology* ; Pregnancy Outcome/epidemiology* ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Prospective Studies ; RNA, Viral/analysis* ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Singapore/epidemiology* ; Umbilical Cord/pathology* ; Young Adult