Worried about Mother to child transmission


My name is Dee and I’m new to the forum, and super thankful for it.

I was diagnosed with CHB in 2013, and my viral load has been relatively low, so I haven’t been place on any treatments.

I recently had a baby, and I had routine scans and tests during pregnancy to monitor my viral load. I was told that I didn’t need any medication going into my 3rd trimester due to my low VL (please see the image).

Here’s my worry, my baby didn’t get the vaccine immediately, even though I kept asking for it and challenging. Vaccine was administered the next day (within 24hrs) after several arguments with the hospital staff.

I have since challenged this and it’s being investigated, but my liver consultant said the chances of transmission is very low due to my low viral load, and also due to the fact that I had a Cesarean Section.

My child has received all the help b vaccine, just waiting to get the 12 months, then get tested.

I’m so worried and each time I think about it, I’m said and anxious because I feel like I may have hurt my child.

Is the consultant right, or have I just been told this to calm my nerves?

Thank you.

Dear @dee,

Thanks for your question and sorry to hear about the stress you’ve been under. It’s also really frustrating that your requests were not responded to.

However, indeed, the risk of transmission is quite low due to your low viral load. Infants who have been given birth dose (defined as within 24 hours of birth) are adequately protected. See figure 2 in this WHO report (page 29 of the PDF https://apps.who.int/iris/bitstream/handle/10665/333391/9789240002708-eng.pdf). It shows that maternal virus levels less than 20000 do not result in a chronic infection in newborns, who are very highly susceptible to chronic infection.

Hope this helps,

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Hello Thomas,

Thank you very much for your response, it’s quite reassuring and I continue to hope for the best.




I completely understand your fear. However, your baby was vaccinated within 24 hours and should be well protected especially that your viral level is low. I have 3 kids, and I was always worried if any of them got infected during the birth. However, they were all checked when they turned 1 and they were all good. So I totally understand your fear, because I went through that fear with every of my child.


Hello Mr @ThomasTu

I have a few questions as a new mom of a 8-day old baby boy.

I just gave birth on the 13th of March 2024 and fortunately, the hospital had given HBIg and Hep B 1st dose to my baby within 24 hours. My doctor suggested me to breastfeed. I’ve been doing it for 8 days as of 21 March 2024. However, I have noticed that my nipples are cracked and sometimes I can see red spots (due to bleeding, I think). Is there a chance of transmission of hep b virus to my baby via cracked and bleeding nipples? My current status: HbsAg 5.47 IU/ml as of 7 March 2024 and HBV DNA 50 IU/ml as of 4 Dec 2023. My baby only received HBIg and Hep B first dose.

Thank you,

Worried Mom

Hello Ms Angie, regarding breastfeeding, what did you do when you had cracked and bleeding nipples?

Hello, I was breastfeeding normally all three kids. However, when I had a broken skin on my nipples I waited when it healed up, and I was pumping the milk from that breast until it was healed up. Use the lanolin it helps with healing or there is also egyptian magic cream that is very good for healing quickly.

Hi @Jodie_2nd,

Congratulations on your child! How fantastic! Hope all is going well.

My understanding is that breastfeeding is recommended even if you are Hep B positive. There is some advice from the CDC and hepatitis B foundation regarding cracked nipples: Hepatitis B or C Infections | Breastfeeding | CDC and Hepatitis B Foundation: Breastfeeding with Hepatitis B.

I’m not sure I can add onto this. Given your viral load is quite low, the risk of transmission is also quite low.

Hope this helps,

Hello everyone, thanks for your response to my initial post.


My child has done the 1 year blood screening.

Result: Negative for surface antigen and positive for surface antibody more than 100.

Core antibody suggesting past infection and has mounted a good immune response.

A repeat blood test will be done in 4 months.

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Hi Dee,

Great to hear that they have protective anti-HBs levels! I’m sure that’s reassuring for you and your family.

Hope all is going well otherwise,

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