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Protecting your baby against hepatitis B guide

Updated 11 January 2021

Hepatitis B infection and the risk to your baby

Each year in the UK, around 3,000 babies are born to women who have hepatitis B infection. This infection is caused by a virus that is spread through blood and attacks the liver.

During childbirth, your baby is in contact with your blood so there is a chance that the virus is passed on to your baby. If this happens, your baby could become infected, 9 out of 10 exposed babies will develop chronic (long-lasting) infection.

This can lead to liver disease such as scarring of the liver (cirrhosis) and liver cancer, which stops the liver from working properly.

Hepatitis B infection can be prevented by vaccination.

How you can protect your baby

Talk to your midwife and register your baby with a GP as soon as you can so that their vaccines can be ordered. You can find a list of local GPs by town or postcode.

Make sure that your baby:

• has their vaccines at the right age from birth
• completes the full course of vaccines
• has a blood test for infection when they reach 1 year of age

Hepatitis B vaccine can protect your baby

A complete course of 6 doses of vaccines is needed to fully protect your baby against long lasting (chronic) hepatitis B infection. The vaccine is given as a small injection into the thigh.

Your midwife will know that your baby should have the first dose of hepatitis B vaccine within 24 hours of birth.

Your baby may also need hepatitis B immunoglobulin (HBIG) at the same time as their birth dose of vaccine, if there is a higher risk of infection. Your midwife will tell you if it is needed. HBIG is also given as a single injection in the thigh.

The second dose of single hepatitis B vaccine needs to be given at 4 weeks of age.

The next 3 doses of hepatitis B containing vaccine are routinely given to all babies at 8, 12 and 16 weeks old. These also protect against other serious infections including diphtheria, tetanus, polio, whooping cough and haemophilus influenzae type B.

Your baby’s final dose of single hepatitis B vaccine should be given when they reach 1 year of age. This dose can be given at the same time as their other routine vaccines.

If you are not able to attend any of the appointments, please let your GP know as soon as possible so that another appointment can be arranged.

Testing your baby for infection

Each year, a very small number of babies may develop infection so your baby will be offered a blood test when they are 1 years old. This is to check that the course of vaccines have prevented them from developing hepatitis B.

There are 2 ways that this may be done and your GP, health visitor or practice nurse will advise you which test your baby will have:

1. A heel prick dried blood spot (DBS) test where a sharp point is used to make a small prick in your baby’s heel and a few drops of blood are dropped onto a card which is sent off for testing.
2. Blood test taken from a vein in your baby’s arm or hand.

If they do have the infection, they will be referred to a specialist for treatment to reduce their risk of developing serious liver disease.

If a young infant is infected, they are more likely to develop long lasting (chronic) infection without any signs or symptoms of infection. Even if your baby has no signs or symptoms of infection they should still have the blood test.

Infection can be prevented in 90% of cases if the first dose of vaccine is given at birth and the full course of vaccines is completed on time.

Home birth

If you had your baby at home, check with your midwife that they have ordered the first dose of vaccine (and immunoglobulin if needed) for your baby so it is given within 24 hours of birth.

Moving home

If you move home it is very important that you let your health visitor know and that you register your baby with a new GP as soon as possible so that they can complete their course of vaccines.

Tell your new GP that your baby needs to complete a course of hepatitis B vaccination and have a blood test at 12 months old because they may have been in contact with the virus at birth.

Moving to another country

If you are moving abroad before your baby is one year old, please let your GP know and don’t forget to register your baby with a new family doctor in your new country of residence.

Take your baby’s Red Book with you and make sure your baby receives all of the doses of hepatitis B vaccines on time and has a blood test at 12 months old.

Babies that need to stay in hospital

If your baby needs to stay in hospital they should receive the second dose of vaccine when they reach 4 weeks old and then continue to follow the schedule below.

Keep a record of your baby’s appointments and vaccination dates. These will also be recorded by your midwife, health visitor, practice nurse and GP in your baby’s Red Book (Personal Child Health Record). Bring your child’s Red Book to every appointment.

If you have questions you can speak to your midwife, health visitor, practice nurse or GP.

Hepatitis B vaccination schedule for babies born to women who have hepatitis B infection

It is essential that your baby receives all of the doses in the table below at the right age to protect them from infection.

Age due	Vaccine
Birth	Single dose of hepatitis B vaccine and HBIG (if required)
4 weeks	Single dose of hepatitis B vaccine
8 weeks	Routine childhood vaccines (contains hepatitis B protection)
12 weeks	Routine childhood vaccines (contains hepatitis B protection)
16 weeks	Routine childhood vaccines (contains hepatitis B protection)
12 months	Single dose of hepatitis B vaccine and blood test to check if your baby has hepatitis B infection

Keep your baby up to date with their vaccines

Further information

Further information about hepatitis B is also available at:

Hepatitis B NHS.UK

Children’s Liver Disease Foundation

General enquiries: 0121 212 3839 or email [email protected]

British Liver Trust

General enquiries: 01425 481320 or email [email protected]