Breastfeeding is not contraindicated for mothers living with HCV unless there are other contraindications (e.g., HIV co-infection). Although there is some evidence of HCV in breast milk, when it has been found it has been at much lower concentrations than in blood and there have been no documented cases of HCV transmission through breastfeeding. However, women with a flare-up of chronic HCV with jaundice postpartum, co-infection with HIV, and those who develop cracked, bleeding nipples should stop breastfeeding. These women should pump and discard their milk until their nipples have healed.
There is no need for caregivers to alter normal childcare routines; the use of gloves, masks, or extra sterilization is unnecessary. Blood is the main source of HCV infection; there is no known risk of transmission by saliva, urine, or stools.
For contraception following birth for women not wishing to become pregnant, use of condoms, intrauterine device, and progesterone-only based contraceptives are all appropriate methods. Combined pills should be avoided by those with cirrhosis because of the potential impact on the liver. The extent of liver disease should be evaluated before women are prescribed hormonal contraception or hormone replacement therapy.