The current Redbook, which our hospital refers to for practices around
newborns, says: "Infants born to known HBsAg-positive women should receive
HBIG and hep B virus vaccine, effectively eliminating any theoretical risk of
transmission through breastfeeding. There is no need to delay initiation of
breastfeeding until after the infant is immunized." (p100) This is the most
recent recommendation available.
Infants born to HBsAg-positive women have high possibility of vertical
transmission so should be immunized irrelevant of breastfeeding. The HBIG and
the vaccine are being administered post exposure anyway. The infant should be
immunized but the timing of first breastfeed relative to immunization,
according to current Redbook, is not critical.
Anne Merewood IBCLC

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