Hepatitis B (hereafter referred to as hepatitis B) virus (HBV) infection is prevalent worldwide, and China is a highly endemic area for HBV infection, with a general population positive for hepatitis B surface antigen (HBsAg) of 9.09%. HBV is mainly transmitted through blood and blood products, mother-to-child, broken skin and mucous membranes, and sexual contact. It is generally believed that about 1/3 of HBsAg-positive people in the population originate from mother-to-child transmission, and HBsAg-positive mothers can transmit the virus vertically to their fetuses. Once an infant is infected with the hepatitis B virus, 85% to 90% of them will develop chronic hepatitis B or HBV carriers, and 25% of them will die of cirrhosis and hepatocellular liver cancer in adulthood. Mothers who are HBsAg positive will ask, “Can I have a baby? How can I have a healthy baby? Can I breastfeed? The answer is that HBsAg-positive mothers can have healthy babies, and with proper treatment, HBsAg-positive mothers can breastfeed. Modes of mother-to-child transmission Intrauterine placental transmission, perinatal/partum transmission and postpartum transmission. Perinatal/natal transmission caused by exposure to the blood and body fluids of HBsAg-positive mothers during delivery is the main mode of mother-to-child transmission, so preventing and interrupting perinatal/natal transmission is the key to having a healthy baby. The protection rate of neonates with hepatitis B vaccine alone to block mother-to-child transmission is 87.8%. The double-blocking method of combined immunization (i.e., combination of active and passive immunization) with hepatitis B vaccine and hepatitis B immune globulin (HBIG) after birth, which is recommended by experts, allows HBsAg-positive mothers to have babies with confidence, and the protection rate to block mother-to-child transmission can be as high as 95% to 97%. The specific methods of combined immunization are as follows: (1) HBIG is given to newborns as early as possible within 24 hours after birth, preferably within 12 hours after birth, and the dose should be ≥100 IU, along with 10 μg of recombinant yeast or 20 μg of Chinese hamster oocyte hepatitis B vaccine at different sites; (2) 1 injection of HBIG is given to newborns within 12 hours after birth, followed by the second injection 1 month later HBIG, and one dose of hepatitis B vaccine at different sites at the same time (same dose as before), and the second and third doses of hepatitis B vaccine at 1 and 6 months intervals, respectively. The latter is less convenient than the former, but its protection rate is higher than the former. The pregnant mother does not need to receive 1 dose of HBIG (200 IU) monthly from the 28th week of pregnancy at all for the following reasons: (1) Neither the WHO nor the Ministry of Health of China recommends the above method to prevent mother-to-child transmission of HBV; (2) The common application of HBIG among pregnant women may lead to the production of an immune escape strain of HBV, and if this immune escape strain spreads in the population, the present hepatitis B vaccine will not be able to (3) Injecting HBIG to HBsAg-positive mothers may form antigen-antibody immune complexes, which is potentially dangerous to the mother’s organism; (4) HBsAg-positive pregnant women still have a large amount of HBV replication in the liver, and the dose of HBIG injection is very low and cannot produce the effect of blocking mother-to-child transmission of HBV. Therefore, HBsAg-positive women can have babies and only need active-passive combined immunization for newborns, without the need to immunize pregnant women during pregnancy, which can have a protection rate of 95% to 97% for blocking mother-to-child transmission of HBV. Even with combined active and passive immunization, chronic HBV infection still occurs in infants of HBsAg-positive mothers, especially those with active HBV replication. The immunization failure rate is proportional to the maternal serum viral load, and there can be multiple reasons for immunization failure, such as viral mutation, mode of delivery, and breastfeeding. Intrauterine HBV infection is a difficult area of prevention, and almost all newborns who fail immunization with HBIG and hepatitis B vaccine are caused by intrauterine infection, indicating that intrauterine infection is the most important cause of failure to intercept mother-to-child transmission. The rate of intrauterine infection is mainly related to the level of virus in the blood of pregnant women, as shown by the high rate of intrauterine infection in those with high HBsAg titers, HBeAg positivity and high levels of HBV DNA replication. Therefore, it is better for these women to take a break from treatment and wait for HBeAg to turn negative and HBV DNA to turn negative before pregnancy. It is not possible to say which of the two types of births, cesarean or natural, is safer or more likely to cause transmission than the other. Cesarean delivery also exposes the fetus to large amounts of maternal blood and does little to prevent fetal infection. The incidence of leakage of HBsAg-positive maternal blood into the fetal circulation is closely related to the length of labor and delivery, and the fetus of an HBV-infected woman should be cleaned of body dirt as soon as possible after delivery to reduce the amount of maternal vaginal secretions or HBV in the blood infects the newborn, and HBIG should be applied to the child as soon as possible and as early as possible to effectively remove the small amount of virus infected because of skin breakdown, and to effectively remove the virus when it has not yet infected the liver. Whether or not a person with HBV infection can become pregnant also depends on whether the liver itself can withstand the burden of the entire pregnancy and delivery process. Women with the following special conditions should always become pregnant under the guidance of a specialist to ensure the safety of mother and child and to maximize the interruption of HBV transmission to the next generation (1) Current acute hepatitis B with significant liver function abnormalities, it is best to delay pregnancy until the disease is stabilized; (2) Patients with chronic hepatitis B with active viral replication and more pronounced liver function abnormalities, often accompanied by inverted protein ratio or hypoproteinemia; (3) Longer HBV infection and severe liver damage, liver biopsy confirmed cirrhosis, with significant platelet (4) women with chronic hepatitis B with severe extrahepatic systemic manifestations such as nephropathy and aplastic anemia; (5) women who have a history of pregnancy but terminate the pregnancy due to deterioration of liver function that cannot tolerate the pregnancy. Breast milk is the most ideal nutritional food and drink for infants, containing all the nutritional elements required for infant growth and development from 4 to 6 months, and suitable for digestion and absorption by the infant’s gut, therefore, breastfeeding is done as much as possible. HBsAg can be detected in the breast milk of mothers with hepatitis B. However, there are no reports of hepatitis B virus particles being detected in breast milk, so it is inconclusive whether their breast milk is infectious. It is usually believed that a mother may transmit HBV to her baby only if her nipples are broken and the child has oral ulcers. The mother should wash her hands with soap and water before feeding to reduce the chance of contact transmission. However, when the baby has a wound in the mouth or the mother’s nipple is broken, it is better to feed manually to reduce the chance of being infected. The hepatitis virus is present in the saliva of mothers with hepatitis B. Therefore, mothers should not feed their children mouth-to-mouth and should pay attention to sterilization and isolation. However, some experts believe that if the mother is at this point in the virus replication period, it is not advisable to breastfeed the baby, and artificial feeding methods should be used to reduce the chance of infection in the baby. Hepatitis B vaccination is an effective measure to prevent HBV infection. Therefore, many parents believe that as long as their children are born with the hepatitis B vaccine and HBIG, and are not infected with HBV and have acquired immunity, everything will be fine and they will not be infected in the future. In fact, this idea is wrong. It has been clinically proven that the hepatitis B vaccine is very safe and effective, and the immunity of children can last for a long time after the program vaccination (i.e. 10μg of recombinant yeast or 20μg of Chinese hamster oocyte hepatitis B vaccine is injected within 6 hours after birth, and the same dose of vaccine is injected after 1 month and 6 months respectively), and the immunity can be maintained for 4-5 years. However, at 4 weeks of age, a booster shot is required (only one shot is needed because the body has a “recall response” from the original immunization) to produce higher antibodies. The child will not transmit hepatitis B through ordinary contact with the HBV-positive mother, such as kissing, sharing towels and eating (unless there is a break in the mouth or digestive tract). However, a little break in the skin in daily life (such as mouth ulcers, abrasions, etc.) may infect a child with HBV, whether adult or child, if he or she comes in contact with supplies containing the blood of a hepatitis B patient or supplies contaminated with HBV. type syringes or strictly sterilized instruments to eliminate medical transmission. Hepatitis B threatens every person and every family, and affects the development and stability of society. It is the responsibility of the whole society to prevent hepatitis B, especially the mother-to-child transmission of hepatitis B.