Pregnancy and breastfeeding with hepatitis B
What is hepatitis B?
Hepatitis B is a virus that causes liver damage and increases your risk of developing liver cancer.
Pregnant women are routinely screened for hepatitis B since the virus can be passed to their baby during birth. Some people can be carriers of the disease even if they have never had any symptoms, which means they can infect other people, including their baby.
How is hepatitis B spread?
Hepatitis B is spread through contact with the bodily fluids of an infected person, including blood, semen and vaginal fluids. During birth, a mother with hepatitis B can pass the infection to her baby. Children can become infected if they have a sore or open wound and have close contact with someone who has hepatitis B.
Other ways to become infected include:
- sexual contact involving penetration without a condom
- injecting drugs using equipment that has been contaminated with hepatitis B
- getting a tattoo or body piercing using equipment that has been contaminated with hepatitis B
- undergoing unsafe medical practices, including blood transfusions in some overseas countries
- accidental needle stick or blood splash into the eyes, mouth, nose or genitals
What are the symptoms of hepatitis B?
Symptoms of hepatitis B can show up several weeks or months after a person is infected and will generally go away after about 6 months. Some people do not manage to clear the infection entirely and will become carriers of the virus.
Symptoms of infection include:
- loss of appetite
- nausea and vomiting
- abdominal pain
- yellow skin or eyes
- dark coloured urine and pale faeces
- muscle and joint pain
Around 1 in every 2 adults and up to 9 in 10 children who are infected with hepatitis B will experience no symptoms.
Should I have a blood test for hepatitis B?
All pregnant women are tested for hepatitis B as part of routine pregnancy screening. If your test comes back positive, your doctor may ask you to redo the blood test to confirm the result.
Can hepatitis B be treated? Is there a vaccination?
Hepatitis B can be treated with antiviral medication and regular monitoring. Antiviral medications may also be used to reduce the amount of hepatitis B in your blood before your baby is born.
All children are vaccinated against hepatitis B as part of the National Immunisation Program.
How might hepatitis B affect my pregnancy?
Having a hepatitis B infection does not usually impact your pregnancy, but there is a risk you will pass the infection on to your newborn during birth.
How do I prepare for labour and birth?
Your labour and delivery will not be impacted if you have hepatitis B. Your doctor will monitor the level of the virus in your blood during the pregnancy and may ask you to take medication to reduce it if it is too high. This will help reduce the risk of your baby becoming infected. Within 12 hours of your baby being born, they will receive an injection of hepatitis B immunoglobulin as well the normal hepatitis B vaccine, which all babies receive.
How can I reduce my risk of transmission?
If the amount of virus in your blood is high, you can reduce the risk of transmitting the virus to your baby by taking medication. This, together with the injections your baby will receive shortly after they are born, will reduce the risk to just a 1 in 20 chance of transmission. It is also important that your baby receives all their usual hepatitis B vaccinations on time — at 2, 4 and 6 months.
Can I still breastfeed if I have hepatitis B?
Breast milk will give your baby the best start possible, and you can safely breastfeed if you have hepatitis B so long as your baby has received the recommended course of vaccinations.
If I have hepatitis B, what does this mean for my newborn?
If you have hepatitis B, your baby will receive an injection of hepatitis B immunoglobulin shortly after they are born. They will then need to be screened for immunity at 9 months of age. Around 95% of babies born to mothers with hepatitis B will not become infected.
In addition, all babies born in Australia receive 4 doses of the hepatitis B vaccine as part of the National Immunisation Program. You will be able to care for your baby normally at home.
Help and support
If you are concerned that hepatitis B could be affecting your pregnancy or newborn baby, you can contact one of the following organisations for help:
- Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse.
- Hepatitis Australia — call 1800 437 222
For more information about the National Immunisation Program call 1800 671 811.
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Last reviewed: August 2021