North American Registry of Midwives (NARM) Practice Exam

How should newborn infants of Hepatitis B infected mothers be managed?

1. Immediate bath, immunization with Hep B immune Globulin (HBIG), and immunization with Hep B vaccine

2. Observation for 48 hours and routine vaccinations

3. Breastfeeding immediately and follow-up check in two weeks

4. Intravenous fluids and observation only

The correct answer is: Immediate bath, immunization with Hep B immune Globulin (HBIG), and immunization with Hep B vaccine

The management of newborn infants born to mothers who are infected with Hepatitis B is crucial to prevent the transmission of the virus. The correct answer involves immediate intervention that includes an immediate bath to reduce the risk of virus transmission through contact with maternal blood or fluids, followed by the administration of Hepatitis B immune globulin (HBIG) along with the Hepatitis B vaccine. HBIG provides passive immunity and helps prevent the virus from establishing an infection in the newborn. The timing of these treatments is essential, as they are most effective when administered within 12 hours of birth. The subsequent vaccination with the Hepatitis B vaccine ensures that the newborn can develop active immunity against the virus, offering long-term protection. Other management strategies, such as merely observing the infant for 48 hours, do not adequately address the immediate risk of Hepatitis B transmission. Routine vaccinations or simply monitoring without the administration of HBIG and the vaccine may leave the infant vulnerable to infection. Similarly, approaches focusing solely on breastfeeding or intravenous fluids fail to provide the necessary preventative measures to protect the infant from Hepatitis B. Thus, the first choice correctly outlines a comprehensive and proactive management strategy for these newborns.