Two hepatitis B mothers or mothers-to-be have come to talk about their woes, one afraid to get pregnant because of hepatitis B, and one afraid to breastfeed after having a baby. I believe there are many people facing the same problems as they do, so I’m here to talk about the concerns of hepatitis B mothers. The full name of hepatitis B is viral hepatitis B. It is a disease caused by hepatitis B virus infection. China is a big hepatitis B country, about 80 million to 100 million people suffer from hepatitis B, the ensuing cirrhosis, liver cancer treatment are very tricky, so people talk about hepatitis B and become afraid. The reason for the high prevalence of hepatitis B in China is the long-standing backward medical and health care level that was once the main culprit. The lack of strict sterilization of various medical devices and unmonitored blood transfusions can lead to large areas of medical- and blood-borne infections. Of course, this was a problem in the past, and with improved sanitation, this mode of transmission has become rare, but the large number of hepatitis B patients already in existence is still a source of virus spread, and can also infect the next generation through vertical transmission from mother to child. How to cut off this route of transmission is now the top priority of hepatitis B prevention and control. I will only talk about this small part of hepatitis B today. 1. If a mother has hepatitis B, will she pass it on to her child through childbirth? Answer: Yes. The mother, whether she is a hepatitis B patient or carrier, whether she is a major or minor triplet, will mostly pass the hepatitis B virus to her offspring during and after childbirth, and only a small percentage will infect the child in utero. Even in the less infectious small triplets, even some hepatitis B DNA-negative mothers can develop a newborn infection during labor. So this means that hepatitis B mothers must prevent these viruses from causing lesions in their babies through subsequent immunoprophylaxis, and since they are all at risk of infection, there is no need to be unnecessarily concerned and worried about the hepatitis B virus situation during pregnancy, and there is no need to be infertile simply because of a high viral load. That leads us to the second question. 2. Can a hepatitis B mother be pregnant at any time? Answer: Not really, the effect of liver function level and antiviral medication should be considered. Hepatitis B mothers need to have their liver function routinely checked before pregnancy, and they can get pregnant if they have hepatitis B infection but no abnormal liver function, but if they are receiving antiviral treatment, whether it is interferon or oral antiviral drugs, it may affect fetal development, and pregnancy is not recommended either. After pregnancy, the liver function should also be followed up, and the recommendation is once every 1-2 months. The presence of mild liver function abnormalities does not require medication, but only observation and review. After pregnancy, the third problem comes up again. 3. Do mothers with hepatitis B need to receive hepatitis B immunoglobulin injections and antiviral treatment during pregnancy? Answer: Neither is needed. Many doctors recommend immunoglobulin injections for hepatitis B mothers, claiming that they can reduce the spread of hepatitis B. This is also mentioned in the current Baidu encyclopedia, but in fact, it is not useful, including animal tests and studies have confirmed that hepatitis B immunoglobulin injections during pregnancy do not have an effect on the production of hepatitis B antibodies in newborns and are unnecessary treatment. In addition, although the rate of neonatal prophylactic failure is higher in viral-positive mothers with major triplets than in viral-negative mothers with minor triplets for the same formal immunoprophylaxis, it is not a significant difference (about 5% and 2%, respectively), and coupled with the side effects of antivirals, antiviral therapy is not currently recommended in mid- to late-pregnancy. That mothers-to-be patiently wait until the birth, immediately is the key moment of virus transmission, the fourth problem arrived. 4. Do I need a cesarean section in order to reduce mother-to-child transmission of hepatitis B? Answer: No, it is not necessary. It was previously thought that natural birth would lead to an increase in intrauterine as well as labor infections, and cesarean delivery was recommended for mothers with hepatitis B. However, studies have actually shown that with regular postpartum immunoprophylaxis, the rate of hepatitis B infection in newborns due to cesarean delivery is as low as that due to natural delivery, so there is no need to perform a cesarean delivery on the grounds of reducing mother-to-child transmission. Okay, here comes the most exciting moment, the baby is born, what do we do? 5. How can newborns be immunized against hepatitis B? Answer: Hepatitis B vaccination and hepatitis B immunoglobulin injection. First of all, the baby should be injected with immunoglobulin within 12 hours. Soon, protective antibodies will be produced and persist for more than 1 month, and only such an injection is needed, not another one after a month as suggested by some hospitals, because the active immunity in the body has been produced before the protective antibodies disappear, and the second time is no longer meaningful. Of course, in special cases, such as premature babies weighing less than 2,000g, it is still recommended to come again after 1 month. After the hepatitis B immunoglobulin injection, it is fine to receive three more shots of hepatitis B vaccination at 0, 1 and 6 months, just like other babies. 6. Can a mother with hepatitis B breastfeed? Answer: Yes. Although a small amount of virus can be detected in the breast milk of a mother with hepatitis B, sometimes a relatively large amount of virus may enter the mouth of a child due to bleeding from a ruptured nipple while sucking on the nipple. However, newborns who have received regular immunization have protective antibodies, and with the environmental problems of the mouth and gastrointestinal tract, it is difficult for the virus to enter the baby’s body. Mother’s. The small percentage of newborns that fail to be immunized against hepatitis B does not happen during breastfeeding. Of course, it is still necessary to expose young children to less blood and vaginal secretions with higher amounts of virus, when you can. Be careful not to have large trauma to the nipples, underwear should be placed and washed separately from the baby’s clothing, etc. 7.When should I go for follow-up laboratory tests for hepatitis B for my baby? Answer: After 7 months of age. In the early neonatal period, since various maternal antibodies can affect the results of laboratory tests through the placenta, it is generally recommended that as long as there are no symptoms of hepatitis, there is no need to check for hepatitis B markers before 6 months of age. The baby will know if it is a successful immunization based on the hepatitis B surface antigen status and the antibody status at 7 months of age. If it is a successful immunization with negative surface antigen and positive surface antibody, 1-2 more follow-up visits before the age of 10 will be sufficient, and in case the antibody titer decreases, another vaccination can be given, which is not necessary after the age of 10. It is not necessary to do this because many people ask for a catch-up vaccination because they find that their hepatitis B antibody titers are low or have turned negative. The first thing you need to do is to get the hepatitis B virus. The actual fact is that you can find a lot of people who have been in the business for a long time. 8. How should the child of a hepatitis B father be handled? Answer: The same. The father of hepatitis B will have the hepatitis B virus in his semen, but it is extremely rare for the virus in the semen to cause intrauterine infection in the fetus, so the children of the father of hepatitis B do not need to receive hepatitis B immunoglobulin injections? The answer is no. This is because the special skin structure of newborns is prone to breakage, and dads in close contact may pass their virus to their babies, so children of hepatitis B dads cannot receive only hepatitis B vaccination like other children, and must receive hepatitis B immunoglobulin injections like children of hepatitis B mothers. In addition, as mentioned at the beginning, hepatitis B mothers are not allowed to get pregnant during the application of antiviral therapy, but fathers can have children during antiviral therapy, antiviral drugs do not affect sperm activity and do not cause sperm mutation, I have seen people who have to stop good antiviral therapy in order to have children, which is a great pity, it is not beneficial. There are no restrictions for hepatitis B dads, and you can have a baby during the antiviral period as well. 2, hepatitis B immunoglobulin in blocking mother-to-child transmission only need to be injected within 12 hours of birth, low weight premature babies can be reinforced once more, the rest, whether pregnant mothers, or newborns who have passed the first day of life, are completely unnecessary. 3, hepatitis B father to have children to interrupt the problem of antiviral treatment, there is really no clear domestic standards, but with the impact of antiviral drugs on sperm basically no view, I do not think there is any problem, interrupting the hard-won antiviral opportunity, it is really a greater impact. 4, all hepatitis B mothers mentioned in the article refers to all hepatitis B chronic infection, including both hepatitis B patients and hepatitis B carriers.