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 Please help with this question!  



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Author4 Posts
  #1

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!




  #2

Well from everything i've read so far go with A because it is CI to breastfeeding when the mom is HBsAg + UNTIL the neonate has received vaccination with Hep B and Hep B immunoglobulins. Also since the neonate was born to a mother who was HBsAg + we should complete all 3 series of vaccinations by 6mths of age (alittle quicker vaccination series for Hep B in this circumstance).

I hope that will clear up some stuff. I would def go with A though from the answer choices


  #3

Correct answer is B.

HBs Ag positive is not a contraindication for Breast feeding. Only thing you have to start vaccine and immunoglobulin to the neonate.  remember that BF has many other advantages ant colostrum is very essential for newborn and it is anti-infective so if you withold BF it will lead to other problems in newborn, so you must start BF.


  #4

Hi,
According to CDC, there is no contraindication to breastfeeding before immunization
http://www.cdc.gov/breastfeeding/disease/hepatitis.htm





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