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请教关于乙肝哺乳的问题
1621
11
2009-05-12 06:33:00
根据这里ＣＤＣ的ｇｕｉｄｅｌｉｎｅ，ｉｎｆｅｃｔｅｄ ｍｏｔｈｅｒ是可以ｂｒｅａｓｔｆｅｅｄｉｎｇ的，如果宝宝出生马上接受疫苗和被动免疫的话。将来宝宝完成３针免疫之后建议查一个乙肝抗体，确保身体产生了抗体了。大概是９到１２个月的时候
另外建议ｍｍ怀孕期间要检测ｌｉｖｅｒ ｆｕｎｃｔｉｏｎ，多休息，避免劳累。
[此贴子已经被作者于2009-5-12 12:03:44编辑过]
我一直大三阳的，第一个孩子出生后打了一针疫苗和免疫球蛋白，是健康的，这个想哺乳，但是有点担心。
我一直大三阳的，第一个孩子出生后打了一针疫苗和免疫球蛋白，是健康的，这个想哺乳，但是有点担心。
en,理解你的心情。美国这边医生的看法是 breastfeed的好处 大于 母乳传染病毒的风险，所以提倡母乳喂养的。况且已开始宝宝接受被动免疫，血液里有抗体的，应该问题不大。
国内的医生观点比较保守，觉得不能take一点点地risk，不要母乳喂养。
非常感谢楼上的回复，另外请教，在国内一般乙肝孕妇在孕7.8.9三个月要分别注射免疫球蛋白200U/次，但
有资料表明这期间注射的医生所建议的量太小，没用，但量大反而有害，因为这种蛋白只有在肝移植中才会大剂量
应用。不知国外是否主张孕期注射乙肝免疫球蛋白？谢谢！
免疫球蛋白在3个孕期都是catagory C的，有动物实验证明有副作用，但是目前没有human study的结果。据我所知这里是不用的，就是宝宝出生后立即打。
这里给孕妇打免疫球蛋白的一般都是本身没有感染，孕期exposure，作为 post exposure prophylax
这里摘抄 免疫球蛋白的indication，供你参考
Hepatitis B Immune Globulin (Human) may be used for the following patients:
- Sexual partners of persons with hepatitis B.
- Persons who may be exposed to the virus by means of blood, blood products, or human bites, such as health care workers, employees in medical facilities, patients and staff of live-in facilities and day-care programs for the developmentally disabled, morticians and embalmers, police and fire department personnel, and military personnel.
- Those who have household exposure to persons with acute hepatitis B and babies less than 12 months old whose caregiver tests positive for hepatitis B.
- Babies born to mothers who test positive for hepatitis B
乙肝表面抗原阳性、e抗原阳性和核心抗体阳性就叫“大三阳”。HBeAg is the on highly infectious.
American Academy of Pediatrics stated that HBV infection not be considered a contraindication to breastfeeding of infants who receive the HBIG and HBV vaccine as advised. Prior to vaccine developed, because many infants became infected before the availability of immunization, there was concern about the additional risk that breastfeeding might confer. Of course, there is a possibility that before your infant develops immunoglobulin (there is 1-5% possibility infant doesnt' mount antibody from the vaccine, you know, nothing is 100%), the infant will have risk from exposure HBeAg from milk. Experts on hepatitis, however, do have concerns that breast pathology such as cracked or bleeding nipples or lesions with serous exudates could expose the infant to infectious doses of HBV.
所以觉得哺乳没有问题,假如宝宝打了疫苗和球蛋白,但是我建议一旦乳头有开裂,出血等现象,暂时停止哺乳
谢谢楼上的答复！
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