For women with chronic hepatitis B, delivering a healthy baby is a dream, and this is gradually becoming a reality. At this stage, the chance of hepatitis B virus infection for new hepatitis B babies is less than 1 in 1,000, which is good news for the majority of hepatitis B mothers. At present, China has already implemented free immunoblocking for babies of hepatitis B mothers, and the efficiency of blocking can reach 95%, which is quite ideal. The specific implementation is as follows: after the delivery of the fetus, hepatitis B immunoglobulin and hepatitis B vaccine are injected as early as possible and hepatitis B vaccine is injected at the age of 1 month and 6 months respectively. The implementation is simple and the effect is obvious. Nevertheless, this national policy is not widely implemented in many hospitals with poor conditions, which leads to a certain percentage of children with hepatitis B in China. In my daily work, I often encounter mothers-to-be consulting related issues, I roughly sorted out, on some hot issues to answer one by one. Q: Do mothers with hepatitis B choose cesarean section or normal delivery when giving birth? Which is safer? A: The choice of delivery method for mothers with hepatitis B is based on the judgment of obstetricians and gynecologists. If it is allowed to have a normal delivery, then it can be chosen; if it is safer to have a cesarean section, then you should listen to the advice of obstetricians and gynecologists. There is no significant relationship between different modes of delivery and the chance of vertical transmission to the fetus. However, if there is prolonged labor or bleeding from a torn birth canal, the chance of transmission may be higher, so it is important to consult an obstetrician before delivery and make a reasonable choice. Q: What are the factors affecting the chance of transmission from mother to fetus? A: First of all, it is clear that hepatitis B virus quantification (HBV-DNA) is an absolute influencing factor. Many mothers are triple positive carriers with normal liver function but high viral loads, and the chances of transmission from these mothers to the fetus are relatively high, but not 100%. In this case, the infectious disease physician should be fully consulted to guide the antiviral treatment. The antiviral treatment at this time is not necessary for the treatment of the condition, but rather for the temporary reduction of the viral load and the chance of transmission. Generally speaking, mothers start to take “Tibivudine or Tenofovir” for antiviral treatment in the seventh month of pregnancy, and after delivery, the fetus will undergo immune blockade, which is more efficient at this time, and slowly try to stop the medication after the delivery of the fetus. Q: Can mothers with hepatitis B breastfeed? A: Almost all mothers have concerns in this regard. It is certain that a fetus that has undergone normal immune blockade can be breastfed, which is now proven to be safe. However, if nipple bleeding or rupture occurs, it is recommended to suspend breastfeeding, as blood exposure can increase the chance of transmission. Breastfeeding can also be done normally while taking antiviral medication in late pregnancy. The medication is secreted through the breast milk and is safe for the fetus. Q: Does the child born to a healthy mother and a father with hepatitis B need to be immunoblocked? A: We know that hepatitis B virus infection in the child is called mother-to-child transmission, which literally means that it is passed from the mother to the fetus. At present, it is basically confirmed that the chance of transmission of hepatitis B from the father to the child is very low, almost negligible. Therefore, the fetus delivered does not need to be immunoblocked, but needs to receive the national vaccination. Q: Do mothers with hepatitis B need to take hepatitis B immunoglobulin during pregnancy? A: In the original guideline, it was recommended that mothers with hepatitis B should be given hepatitis B immunoglobulin injection during late pregnancy to reduce the chance of mother-to-child transmission, which is now denied and there is no point for such mothers to be given hepatitis B immunoglobulin injection, so they do not need to be given it. If you have some other questions that are not mentioned above, please feel free to note them in the comment section and I will update them regularly. I hope to be able to help families and give birth to healthy babies. This article is authorized by Dr. Xing Jiyuan, please do not reprint without authorization.