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Old 10-12-2011
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Kids Hepatitis B Positive Mom feeding her newborn!

You get a call from a pregnant hepatitis B surface antigen positive woman that you have been taking care of. She is frantic because she unexpectedly went into labor and delivered the baby in her bathtub 30 minutes earlier. She had her husband cut the cord with a clean kitchen knife and the baby appears to be doing well. She wants to know if you can see her immediately. She is concerned about how her hepatitis status affects breast-feeding. You tell her to bring the baby over to the office and

A. not to breast-feed until the baby received the proper immunizations
B. that she can begin to breast-feed immediately if the baby is hungry
C. that her newborn will need to be treated with alpha interferon
D. that her breast milk does not contain hepatitis B surface antigen
E. that she should not breast-feed the newborn because of her hepatitis status



on MTB for step 3, at page 393, there is a chart with breat feed contraindication....it says if mother has infection with HIV, active TB, HEPATITIS B BEFORE THE BABY IS IMMUNIZED, etc, breastfeeding is contraindicated; I choose answer A....the right answer is given as B and this is the explanation: 'The correct answer is B. Even though the breast milk from a hepatitis B surface antigen positive woman contains the hepatitis B surface antigen, according to the American Academy of Pediatrics and the Report of the Committee on Infectious Diseases, breast-feeding does not significantly increase the risk of infection. Newborns born to HBsAg positive women should be given the hepatitis B vaccine and hepatitis B immune globulin as soon after birth as possible, but breast-feeding does not need to be delayed until after immunizations. Therefore, she should be advised that she can begin to breast-feed immediately if the baby is hungry.

As stated above, it is not necessary to wait to breast-feed until after the baby is immunized. Therefore, telling her not to breast-feed until after the baby receives the proper immunizations is incorrect(choice A).'


I have to mention this is an offline qbank named 'MCQ for step3'....I have no ideea which year or from which source is; if anybody has a good sugestion about who to belive, I would higly appreciate it! I personally would trust MTB....

Thanks to anybody who's willing to help!
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Ace3 (10-15-2011)



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Old 10-15-2011
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Even in Kaplan CK Notes pg 66 in obs part in step 2 ck it gave breast feed is acceptable if neonate of hbsag positive mother has received (active immunization that is) vaccine and (passive immunization that is) hbig.

and if mother is hepatitissurface antibody positive then i think breast feed can be started and also no risk for perineal transmission.

and what about mother since as we diagnose her hbsag positive then next--->we should check for if it is active or chronic hepatitis so how should we approach from here next and treatment can be started in pregnency or after delivery?
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Old 10-16-2011
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Quote:
Originally Posted by confident View Post
Even in Kaplan CK Notes pg 66 in obs part in step 2 ck it gave breast feed is acceptable if neonate of hbsag positive mother has received (active immunization that is) vaccine and (passive immunization that is) hbig.

and if mother is hepatitissurface antibody positive then i think breast feed can be started and also no risk for perineal transmission.

and what about mother since as we diagnose her hbsag positive then next--->we should check for if it is active or chronic hepatitis so how should we approach from here next and treatment can be started in pregnency or after delivery?

Thanks for replying to my post....I am still confuse about the right answer/management in this situation. Both sources(MTB and the Qbank) agree on the management AFTER the baby will receive the proper vaccination and Ig for HBV but my question remains what do we do BEFORE the baby receives the immunization because MTB says breast feeding is CONTRAINDICATED until the beaby will receive the immunization, whereas the Qbank says it is OK to breastfeed even BEFORE administrating the vaccine+Ig againts HBV? This is my dilema and that's why I post this topic.....
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