A 6-Hour-Old Boy Is Being Evaluated in the Nursery

A 6-hour-old boy is being evaluated in the nursery.  He was born at 39 weeks gestation via spontaneous vaginal delivery to a 33-year-old primigravida.  The pregnancy was complicated by intravenous drug use, and the mother was incarcerated for 2 months during the second trimester.  First trimester serologies, including RPR, HIV antibodies, and hepatitis B surface antigen (HBsAg) , were negative.  Due to the mother's risk profile, follow-up testing was obtained during the third trimester and revealed the following: Liver function testing was normal.  Hepatitis C and repeat HIV testing were negative.  The remainder of the pregnancy was uncomplicated.  The infant weighs 3.7 kg (8 lb 3 oz) .  Physical examination of the infant is normal.  There is no jaundice or hepatomegaly.  Which of the following is the most appropriate next step in management of this infant?

A) Administer hepatitis B immune globulin
B) Administer hepatitis B immune globulin and vaccine
C) Administer hepatitis B vaccine
D) Obtain hepatitis B antibody panel
E) Obtain liver function testing
F) Restrict breastfeeding

Correct Answer:

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