Of the 15 babies born to mothers infected with hepatitis C virus (HCV) and followed since birth, three developed HCV RNA in their serum. HCV RNA disappeared in two infants within 2 mo, but it persisted in the remaining infant. Mother-to-baby transmission was diagnosed retrospectively in an additional eight children aged 0.8-13.6 y. The eight children were followed for 1.4-5.0 y (mean +/- SD: 3.2 +/- 1.3 y) until they were 3.3-16.7 y old (8.5 +/- 4.3 y). Serum HCV RNA disappeared and antibodies to HCV decreased in the titer in two of the children when they were 3 y old. The spontaneous loss of serum HCV RNA was not observed in any of the other 14 children with posttransfusion infection who were followed for 2.6-6.1 y (4.0 +/- 1.1 y), until 3-22 y from the time they received transfusions and when they were 8.4-22.8 y old (15.4 +/- 4.1 y). These results indicate that the vertical transmission of HCV is rare, and some children can resolve the infection after a few years, whereas the infection persists in children who are infected by transfusion.