Breastfeeding with Hepatitis B: Risks and Considerations for Newborns - Obstetrics and Gynecology

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Neonatal Hepatitis B Infection


Hello Dr.
Wu: I am a carrier of hepatitis B, with a positive e-antigen, and I am currently 37 weeks pregnant.
I really hope to breastfeed, but I would like to know how feasible this is.
If the newborn contracts hepatitis B, what would be the potential consequences? Thank you for your response!

Judy, 20~29 year old female. Ask Date: 2000/12/27

Dr. Wu Zongcheng reply Obstetrics and Gynecology


Response: (1) Pregnant women who are carriers of hepatitis B with a positive HBsAg can breastfeed; however, if they are positive for HBeAg, the risk of vertical transmission to the infant is high, and breastfeeding is generally not recommended.
(2) Newborns infected with hepatitis B may experience mild carrier status, while severe cases can present with symptoms of hepatitis B, including jaundice, poor appetite, and liver dysfunction.

Reply Date: 2000/12/27

More Info


Breastfeeding with Hepatitis B: Risks and Considerations for Newborns
As a Hepatitis B carrier with a positive e-antigen status, your concerns about breastfeeding and the potential risks to your newborn are valid and important. Hepatitis B is a viral infection that primarily spreads through blood and bodily fluids, and understanding the implications for breastfeeding can help you make informed decisions for your child's health.

Firstly, it is crucial to note that the risk of transmitting Hepatitis B through breastfeeding is considered to be very low, especially if appropriate preventive measures are taken. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) both recommend that mothers with Hepatitis B can breastfeed their infants, provided that the newborn receives the Hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth. This immediate vaccination is critical as it significantly reduces the risk of the infant contracting the virus.

In your case, since you are a Hepatitis B carrier, the primary concern would be the potential for the virus to be present in your breast milk. While studies have shown that the Hepatitis B virus can be found in breast milk, the concentration is generally low, and transmission through breastfeeding is rare. The risk of infection is much higher through direct blood-to-blood contact, which is not typically a concern during breastfeeding unless there are open sores or bleeding on the mother's breast or the infant's mouth.

If your newborn is vaccinated promptly after birth, the likelihood of them contracting Hepatitis B through breastfeeding is significantly minimized. The vaccine works by stimulating the infant's immune system to produce antibodies against the virus, providing a protective effect. It is also advisable to monitor your infant's health and conduct regular follow-ups with your pediatrician to ensure that they are developing normally and that their vaccination schedule is adhered to.

In terms of what could happen if a newborn were to contract Hepatitis B, the outcomes can vary. Many infants who become infected with Hepatitis B at birth may not show immediate symptoms, but they are at a high risk of developing chronic Hepatitis B infection, which can lead to serious liver complications later in life, including cirrhosis and liver cancer. Approximately 90% of infants who contract the virus at birth will go on to become chronic carriers. Therefore, the importance of vaccination and monitoring cannot be overstated.

In conclusion, breastfeeding while being a Hepatitis B carrier is generally considered safe if the newborn receives the appropriate vaccinations immediately after birth. It is essential to maintain good hygiene practices, avoid any potential blood exposure, and consult with your healthcare provider for personalized advice and monitoring. Regular check-ups for your infant will help ensure their health and well-being, and you can continue to enjoy the bonding experience that breastfeeding provides. Always feel free to discuss any concerns with your healthcare provider, as they can offer tailored guidance based on your specific situation.

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