A mother infected with hepatitis B asks the nurse about the possibility of breastfeeding her neonate. Which response by the nurse would be most appropriate?

  1. “Yes, breastfeeding is an acceptable option.”
  2. “No, you should not breastfeed your baby.”
  3. “Yes, breastfeeding is an acceptable option once your baby is immunized with the hepatitis B vaccine.”
  4. “Bottled formula is just as nutritious for your baby.”
Number 3 is correct.
Rationale: Within 12 hours of birth, children born to HBV-infected mothers should receive the hepatitis B vaccine, making breastfeeding a viable option. The second vaccine should be given to the child at 1 – 2 months and the third dose at 6 months of age. By age 9 – 18 months the infant should be tested for the presence of HBV. Optimal nutrition for newborns consists of exclusive breastfeeding for the first 6 months of age.