Literature review for - Flourish Paediatrics

of birth. Every effort should be made to administer the vaccine before discharge from the
obstetric hospital.
Extensive experience indicates that the birth dose of hepatitis B vaccine is very well tolerated
by newborn infants. It does not interfere with either the establishment or maintenance of
breastfeeding, and it is not associated with an increased risk of either fever or medical
investigation for sepsis in the newborn.
The WHO and UNICEF also recommend that all infants be exclusively breastfed for at least
4 and if possible 6 months, and that they continue to breastfeed up to two years of age or
beyond. There is no evidence that breastfeeding from an HBV infected mother poses an
additional risk of HBV infection to her infant, even without immunization. Thus, even where
HBV infection is highly endemic and immunization against HBV is not available,
breastfeeding remains the recommended method of infant feeding (WHO 1996).
Before the advent of routine hepatitis B vaccination programs in the USA it was estimated
that 30%–40% of chronic infections resulted from perinatal or early childhood transmission
(West and Margolis 1992). In the USA the CDC gives the following counselling message
“Hepatitis B virus is not spread by breastfeeding, kissing, hugging, coughing, ingesting food
or water, sharing eating utensils or drinking glasses, or casual contact (Centers for Disease
Control 2005).” However in the USA in the case of hepatitis B positive mothers routine
administration of immune globulin is given with the infant Hepatitis B vaccine.
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