The National Health and Health Commission CDC called on everyone to actively vaccinate, take the initiative to check their health status, and the infected people receive standardized anti-viral treatment to completely curb the threat of viral hepatitis to human health.
Ditan Hospital is mainly for pregnant women with hepatitis B virus. They are unspeakable pains when they are first mothers – they don’t dare to breastfeed their babies after giving birth. Because many studies have confirmed that hepatitis B virus infection factors can be detected in the milk of pregnant women with hepatitis B. Is there any way to protect the baby born to the mother of hepatitis B from the hepatitis B virus and to eat safe breastfeeding? This has been the subject of obstetrics and gynaecology research at Beijing Ditan Hospital. The results of the study showed that breastfeeding did not increase the risk of mother-to-child transmission of hepatitis B in infants under combined immunization conditions.
Personalized program to help mothers of hepatitis B achieve breastfeeding
On December 26, 2011, 32-year-old Wang Qingqing (pseudonym) successfully delivered a healthy baby boy at Ditan Hospital. Qingqing is a big three-yang maternal woman with a blood hepatitis B virus content of up to 107 copies/ml. Through the doctor to develop a personalized blocking and monitoring program, the mother with high hepatitis B virus, the mother and baby are successfully blocked, and the baby who has breast milk is healthy.
Baby surface antigen positive hepatitis B mother insists on breast milk. After the baby was delivered, the midwife took 5 ml of venous blood from the baby to check for intrauterine infection. Subsequently, the medical staff injected the first hepatitis B vaccine and the high-priced hepatitis B immunoglobulin for the infant to block the mother-to-child transmission of hepatitis B.
On the same day, Mr Smith began breastfeeding her baby. The next day, the results of the baby’s examination came out, and everyone poured a cold water: the baby’s hepatitis B surface antigen and HBV-DNA were positive, but the value was not high.
Although it is known that babies may increase their exposure to hepatitis B virus infection factors, Qing Qing still chooses breastfeeding and hopes to receive hospital guidance.
In response to the test results of the birth of the baby, the director of the obstetrics and gynaecology department, Mr Smith cooperated with the doctor to develop an individualized monitoring plan for the baby pebbles, and asked her to take the baby to the hospital for follow-up.
The first injection of immune blockade has an effect. According to the blood test at the time of the baby’s birth, the hospital specially adds a half-month-old blood test to the small stone. The result came out: the first needle’s immune blockade has an effect! Hepatitis B surface antigen and HBV-DNA are all negative, hepatitis B surface antibody (anti-HBs) is positive, and hepatitis B immunoglobulin works!
Complete all normal hepatitis B immune blocking programs. At one month follow-up, the hospital gave a small stone a combined immunization of hepatitis B vaccine and HBIG for 1 month. According to the follow-up results, the index of hepatitis B infection at 1 month of age continued to be negative, and the anti-HBs continued to be positive, indicating that the infant’s intrauterine infection alert was basically relieved.
Because hepatitis B virus can be detected in maternal colostrum and 1 month milk, Mr Smith suggested that she should follow up again in infants 3-4 months, and she promised one by one. At 6 months of age, Mr Smith vaccinated the baby with the last dose of hepatitis B vaccine in the community. At this time, according to the regular hepatitis B immune blocking program, all the hepatitis B vaccine was inoculated.
The autoantibody is too low, and the baby is given a hepatitis B vaccine. In the blink of an eye, the small stone was 7 months old. After follow-up test, the baby was not infected with hepatitis B, and the mother and baby were successfully blocked! However, at this time, the value of anti-HBs in small stones is very low, and there is always a risk of infection. Therefore, the hospital added a shot of hepatitis B vaccine to the baby.
At the age of one year of follow-up, the small stones showed successful maternal and child blockade! However, the protective antibody value of hepatitis B in the body is still not ideal. The hospital also strengthened a shot of hepatitis B vaccine for small stones. When the small stone was two years old, it finally had a very high protective antibody against hepatitis B.
Joint immunization with breastfeeding does not increase the risk of hepatitis B
At the end of 2010, China’s “Guidelines for the Prevention and Treatment of Chronic Hepatitis B” (2010 edition) first proposed that newborns can receive breast-feeding from HBsAg-positive mothers after high-intensity hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine at 12 hours of birth. However, hepatitis B carries different hepatitis B virus infection status in the mother’s machine, and the hepatitis B virus DNA content in the blood also has a huge difference, and no detailed explanation is given in the guide. In order to better guide the clinical and give patients a clearer answer, the Department of Obstetrics and Gynecology, Ditan Hospital, at the end of 2010, filed a research study on the safety of breastfeeding in pregnant women with HBV infection.
Mr Smith is just one of the many successful cases of maternal and child blockade in Ditan Hospital… The research has received a lot of support from Mr Smith , who is infected with different HBV-DNA content. There were 440 mothers of hepatitis B who participated in the study. In the end, 409 infants were followed up from 7 months to 2 years old. The rate of loss of follow-up was only 7.05%, and the final immune failure was only 1.96%.
In 2014, Mr Smith and others finally completed the study on the correlation between serum HBV-DNA and the risk of mother-to-child transmission in breastfeeding.
The results of the study showed that breastfeeding did not increase the risk of mother-to-child transmission of hepatitis B in infants under combined immunization conditions.
When the mother’s HBV-DNA is negative and low in viral content, the baby is basically safe whether it is artificial or breastfeeding;
When the mother’s HBV DNA is ≥ 1.00 × 106 copies / ml, there is a certain risk of infection whether breast-fed or artificially-fed. There are large individual differences in the immune response of infants to hepatitis B vaccine. Especially for infants whose mothers are high in viral content, it is necessary to strengthen the monitoring and immune protection of their infants.
In fact, many HBsAg-positive mothers have achieved safe breastfeeding, but more clinical evidence is still available for breastfeeding of serum HBV-DNA high virus content.
How does breast-feeding mother breastfeeding avoid infection?
At this stage, HBsAg-positive breastfeeding health education is an important part of ensuring the safety of breastfeeding. Doctors should give breastfeeding knowledge to hepatitis B women in advance, telling women how to avoid factors that may increase infant infection, and how to prevent maternal blood and body fluids from contaminating damaged skin and mucous membranes. For example: baby tableware, daily necessities, alone; mother does not chew the mouth to feed the child; mother blood stains do not wash with the baby’s clothes; do not take too long each time, master the correct breastfeeding posture, avoid nipple splitting and The occurrence of mastitis; the timely treatment of infantile diarrhea, etc., these are the problems that hepatitis B mothers and babies should pay special attention to.
When there is a possibility of increasing infection, it is recommended to stop feeding for several days. During the feeding period, the mother can use a breast pump to suck out to maintain the lactation function. At the same time, it is recommended to follow up the follow-up monitoring of infants born to HBsAg(+) mothers.