After ten months of pregnancy, the baby’s arrival makes the mother feel extremely happy, in the face of the little mouth waiting to be fed, young mothers how much they want to breastfeed their babies in their arms! However, the fear of spreading the hepatitis B virus makes mothers with “triple positive” worry a lot. China’s first “Chronic Hepatitis B Prevention and Control Guidelines” clearly states that newborns can receive breastfeeding from HBsAg-positive mothers after receiving Hepatitis B Immunoglobulin and Hepatitis B Vaccine within 12 hours of birth. The Guidelines for the Prevention and Control of Chronic Hepatitis B were jointly developed by the Hepatology Section of the Chinese Medical Association, the Infectious Diseases Section of the Chinese Medical Association, and the China Hepatitis Prevention and Control Foundation under the leadership of the Ministry of Health and the Chinese Medical Association. Adhering to the principle of evidence-based medicine, it only incorporates recognized protocols that have been rigorously clinically validated, and at the same time specifies the standardized treatment criteria for hepatitis B. The Guidelines have been developed by the Chinese Medical Association and the China Hepatitis Prevention and Control Foundation. Its professionalism and authority cannot be questioned. Why is it that some popularized articles on hepatitis B mention that mothers with hepatitis B virus cannot breastfeed their children. The guidelines clearly state that HBsAg positive mothers can breastfeed. Let’s get a little more specific. Can breastfeeding really transmit the hepatitis B virus? Recent studies have allayed this concern: Hepatitis B virus has occasionally been detected in breast milk, but oral feeding to gorillas has not led to infection. The survey of many “triple positive” mothers, breastfeeding and artificial feeding on the baby’s hepatitis B virus infection rate is not significantly different. Domestic scholars Wang Jian and other foreign articles (Int J Clin Pract 2003;57:100-102): 230 newborns of chronic hepatitis B carrier mothers have received hepatitis B vaccine and hepatitis B immunoglobulin injection. There was no significant difference in the number of infants who developed surface antibodies at one year, 90.3% in the breastfeeding group and 90.3% in the non-breastfeeding group. Report of foreign scholars (Hill JB, et al. Obstet Gynecol, 2002;99:1045-1052): 369 newborns of chronically hepatitis B virus-infected mothers, all of whom received hepatitis B vaccine and hepatitis B immunoglobulin injections, were breastfed 101 (average breastfeeding of 4.9 months), and non-breastfed 268, and mothers in both groups Mothers in both groups were 22% and 26% “triple positive” respectively. When these infants were examined at 15 months of age, only 9 (3.4%) of the non-breastfed infants were infected with the hepatitis B virus; none of the breastfed infants were infected. In conclusion, there is no evidence to date that the hepatitis B virus can be transmitted through breast milk. Why does breastfeeding not transmit hepatitis B virus? 1. The chance of detecting hepatitis B virus in breast milk is very low; the amount is also very small. 2.Hepatitis B is a blood-borne disease and hepatitis B virus cannot be transmitted through the digestive tract. 3. Newborn babies immunized with hepatitis B vaccine and hepatitis B immunoglobulin already have protective antibodies in their bodies. Make a biased safe estimate. Assuming that the chance of detecting hepatitis B virus in breast milk is 1%, the chance of hepatitis B virus in breast milk entering the bloodstream through the digestive tract is 1%, and the chance of the virus that enters the bloodstream escaping the human body’s immune attack and leading to infection in the presence of antibodies in the bloodstream is also 1%, the probability of breastfeeding leading to infection is 0.01×0.01×0.01＝0.000001, i.e., one in a million. Is this one in a million chance of infection worth worrying about? Why do we strongly advocate breastfeeding? Breastmilk contains a variety of antibodies that are only found in adults, which are lacking in children, but are very necessary and important for healthy growth in the future, so breastfeeding has always been emphasized in gynecological and pediatric medicine. Breastfeeding is the natural behavior of all animals, and it is crucial for the development of a child’s personality as he or she receives mother’s love and nurturing from the moment he or she is born and sucks on the breast milk. Breastfeeding is very important to the physical and mental development of children, eating mother’s milk is “God” to give children’s “human rights”, do not easily deprive children of their rights. The real reason why babies get hepatitis B Nowadays, the dose of imported hepatitis B vaccine is 10 micrograms per dose, and the dose of domestic vaccine is 5 micrograms per dose. The current dose for newborns is obviously insufficient, the antibody positive rate is about 80%, there are still infections occurring, parents may mistakenly believe that it is the cause of breastfeeding. Thus, there is a risk in advocating breastfeeding, and I wonder if the fact that some doctors and popular science articles do not advocate breastfeeding is relevant. It has been recommended by experts that the dose of hepatitis B immunoglobulin should be 200 IU once, hepatitis B vaccine 20 μg once, one injection of HBIG within 12 h after birth, and a second injection of HBIG one month later, and one injection of hepatitis B vaccine at different sites at the same time, and second and third injections of hepatitis B vaccine at intervals of 1 and 6 months, respectively. 5% of infants from mothers with very high levels of hepatitis B virus (T3/HBV DNA equal to or higher than the 7th power) fail to be immunized, even with a combination of vaccine and globulin. This is due to intrauterine infection. It is rare, but the most difficult to prevent, what to do. It has been reported both nationally and internationally that mothers who start Herceptin at 32 weeks of gestation can have a 2-fold reduction in serum viral levels at delivery. There are no reports of lamivudine causing neonatal malformations, the safety is relatively reliable, and the rate of teratogenicity may be very low, but there are no large-scale clinical trials to confirm this, so it is only for patients to consider with caution. Although the chances of a pregnant woman transmitting hepatitis B through breastfeeding are very low, there are exceptions to everything, so the decision to breastfeed for mothers with hepatitis B is still up to you, and whether or not you choose to breastfeed, I hope you have a healthy baby!