Pregnancy and breastfeeding with hepatitis B

Hepatitis B (also known as 'hep B') is a liver infection caused by the hepatitis B virus. It can be passed to your baby during pregnancy or birth.

How is hepatitis B spread?

Hepatitis B spreads through contact with body fluids from someone with the virus. This includes:

• blood
• semen
• vaginal fluids
• breast milk

Children can get hepatitis B if they have a cut and have contact with someone with the virus.

Other ways to become infected are:

• unsafe sex
• drug misuse with dirty needles
• tattoo parlours
• needle stick injuries or exposure to bodily fluids
• during medical procedures such as intravenous blood transfusions — if these are done in an unsanitary way

Symptoms of hepatitis B infection include:

• fever
• loss of appetite
• nausea and vomiting
• abdominal pain
• jaundice (yellowing of your skin or eyes)
• dark coloured urine (wee) and pale faeces (poo)
• muscle and joint pain

You may notice symptoms of hepatitis B a few weeks or even months after you get infected. Some people have the virus and don't get any symptoms. They can still pass on the infection.

Complications of hepatitis B infection are severe liver disease and liver cancer.

The routine pregnancy screening tests include a check for hepatitis B surface antigen (HBsAg). This test shows if you have a current infection.

If you're in an 'at risk' group for getting hepatitis B the following tests are recommended:

• hepatitis B surface antibody (anti-HBs)
• hepatitis B core antibody (anti-HBc)

Ask your doctor to explain the results.

Treatment for hepatitis B infection includes antiviral medicines and regular monitoring. Antiviral medicines can lower the amount of hepatitis B in your blood before your baby is born.

Your pregnancy shouldn't be affected by having hepatitis B, but you may pass the virus to your baby during pregnancy or birth.

How do I prepare for labour and birth?

If you have hepatitis B, your doctor will monitor your viral load (amount of virus in your blood) during pregnancy.

They may prescribe medicine to help lower the chance of your baby becoming infected.

Will my hepatitis B diagnosis affect my baby?

Most babies don't catch hepatitis B.

Your doctor will also offer to give your baby an injection of hepatitis B immunoglobulin (antibodies). Your baby's immunity will be checked at 9 months old.

All babies can get 4 doses of hepatitis B vaccine as part of the National Immunisation Program. You will be able to care for your baby normally at home.

Your baby's first hepatitis B vaccine is usually given before they leave hospital — ask your midwife for more information.

Is it safe for me to breastfeed if I have hepatitis B?

Yes — you can safely breastfeed with hepatitis B, as long as your baby has their recommended vaccinations.

If your hepatitis B is not treated, your baby has a very high chance of getting the virus at birth. If your baby becomes infected, they are very likely to develop chronic hepatitis B.

You can lower the chance of passing the virus to your baby by taking antiviral medicines.

It's very important to vaccinate your child against hepatitis B. This is free, as part of the National Immunisation Program. It's very important that your baby has all their recommended vaccinations on time.

If you are concerned about hepatitis B affecting your baby call Hepatitis Australia on 1800 437 222.

Hepatitis NSW has a useful factsheet on hepatitis B, pregnancy and babies.

To learn more about childhood vaccinations, visit:

• National Immunisation Program or call the National Immunisation Information Line on 1800 671 811.
• Find up to date vaccination information from the Australian Immunisation Handbook.

Languages other than English

• NSW Health has a useful fact sheet on hepatitis B, which is available in other languages.
• Hepatitis Australia has useful information on hepatitis B and C.

Information for Aboriginal and/or Torres Strait Islander peoples

Hepatitis NSW has a useful booklet on hepatitis B developed for Aboriginal communities.