Dr. Avinash G Kamat

What is Hepatitis B?
Hepatitis B can be defined as the viral infection of the liver. It is caused by Hepatitis B virus (HBV). It is the most common type of virus and can affect a person adversely if left undetected and untreated.

What are the risks to the baby born to Hepatitis B mother?
If the mother has Hepatitis B, there are chances of transfer of virus to the baby. Transmission can occur while the baby is in utero, during delivery and in postpartum period. Most of the cases are due to transmission of virus at the time of delivery due to exposure to blood. That virus can infect the baby and can cause hepatitis in the baby. Baby can become a chronic carrier and can develop liver cirrhosis and hepatocellular carcinoma in later life.

Does breast milk contain Hepatitis B Virus?

Yes, HBV can be found in the breast milk of 70% of carrier mothers, but there is no evidence of transmission of Hepatitis B through mother's milk.

Can Hepatitis B Positive mother give breastfeed to her baby?

Yes, according to WHO and UNICEF guidelines breastfeeding can be given, as breast milk is the natural and optimal feed to the baby. Mother feeding in hepatitis B positive mother infant can be made more safe by immunisation of the baby with Hepatitis B Vaccine and Hepatitis B immunoglobulin . Hepatitis B vaccine and immunoglobulins are to be given within 12hrs of delivery and the vaccine should be repeated after 1 month and 6 months. This will substantially reduce perinatal transmission and virtually eliminate any risk of transmission through breastfeeding or breast milk feeding. Immunization of infants will also prevent infection from all other modes of HBV transmission. Exclusive breast feeding is to be continued till 6 months of age .Start complementary feeds at 6 months of age and along with that continue breast feeding for two years.

What to do if Hepatitis B positive mother has sore or cracked or bleeding nipples?

Mothers should breastfeed the baby carefully so that she would not get cracked or sore nipple. In case she gets sore or cracked or bleeding for nipple ,stop breast feeding and take treatment for sore nipples. Because sore nipples or cracked nipples can transmit the virus through exposure to blood . During that period she should express the milk and discard it. She should resume the feeding after the nipples are healed.

Children are much more susceptible to tooth decay and gum disorders than grown-ups. This is because the gum and teeth in toddlers are very delicate. Moreover, children are more attracted to sweets and other food items, which cause damage to the teeth.

Here are several ways to protect the teeth of your little one:

1. Have a dental checkup: You should take your child to a dentist on his first birthday. Early prevention is important as any kind of problem in the teeth will be detected and this will save you from a lot of trouble in the future.
2. Teaching healthy habits: Brushing is very important and you should teach your child to brush regularly, more than once a day. Before the development of teeth in your baby, you should brush his gums gently by using water on a soft baby toothbrush or with a clean and soft cloth. After developing teeth, brushing must be practiced with delicate toothbrushes and fluoridated toothpaste. If several teeth touch against each other, you should use flossing. Brushing is essential before going to bed, and no food should be taken after brushing.
3. Prevent "baby bottle decay": You should not let your child go to sleep with a bottle of juice or milk. The sugar contained in these liquids sticks to the child's teeth, which activates bacteria and may lead to tooth decay.
4. Avoid giving juice to your child: Juice may be healthy for the body, but it leads to tooth decay in little kids. The amount of regular juice intake should never be above four ounces.
5. Avoid excess use of a sippy cup: Sippy cups enable children to shift from bottles to a glass. However, all day long usage of sippy cups should be restricted as it may cause decay on the front and back portions of teeth, when the drinks are rich in sugar.
6. Be careful about sweet medicines: Many medicines meant for children are sugary and stick to the teeth, increasing the chance of cavities. Several antibiotics cause overgrowth of Candida or yeast and cause an oral disease known as oral thrush. This disease causes creamy patches on the tongue. In case your child needs sweet medicines, brushing should be increased.
7. Stop using a pacifier by the age of 2 or 3: Pacifiers are good for children, but using pacifiers for a long period of time affects the lining of teeth. The shape of the mouth may also change. Hence, do not let your child use pacifiers after 2 or 3 years of age.

Children are quite prone to teeth disorders and decay in the teeth. Hence, measures must be taken to protect the teeth of children from any kind of disorder.