Hep B shot on newborn

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I'm a 3rd semester nursing student. And today, I performed my first Hep B shot on a newborn! I gave him the shot and when i withdrew the needle...he started to bleed a lot!The nurse that I was with said that it happens....but i still can't get over it!

I feel like I hurt the baby really bad because it seemed like a pretty good amount of blood came out! It's 10pm at night and all I wanna do is run back to the hospital to see how the baby's doing. I wanna make sure hes not swollen or anything!

Is it normal to feel this way? Am i just being too hard on myself? Please help!

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Specializes in Community, OB, Nursery.

It does happen sometimes.....no need to be too hard on yourself.

One thing that does help, sometimes anyway, is changing the needle after drawing up the injection and giving the shot with the new needle. Plus, it hurts less.

Some kids just bleed more anyway, but it probably wasn't as much as it looked like. :)

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Specializes in OBGYN, Neonatal.
It does happen sometimes.....no need to be too hard on yourself.

One thing that does help, sometimes anyway, is changing the needle after drawing up the injection and giving the shot with the new needle. Plus, it hurts less.

Some kids just bleed more anyway, but it probably wasn't as much as it looked like. :)

I'm glad you mentioned this, I had never heard/seen this practice before and then someone taught me this when I was on orientation. I'm a diabetic and you know had alwyas used the same needle to draw up my insulin and inject it but then again insulin needles are small fries compared to the hep b needles (or most of our needles anyway LOL). But yes we often do this for our babies!

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I have given hundreds of Hep B injections to newborns and have had some of them bleed a lot. I always aspirate prior to giving the injection and only once have hit a vein and had to get a new vial of medication, though. Just apply pressure and it will be fine. I agree it probably wasn't as much blood as it appeared to be. It is good you are concerned but I hope you are reaassured that everything is okay.

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I know this is off topic but why are we diving Hep B shots to newborns when we know Mom is Hep B negative? Why can't they wait until they are 6-8 weeks old like other immunizations?

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Specializes in Maternal - Child Health.
I know this is off topic but why are we diving Hep B shots to newborns when we know Mom is Hep B negative? Why can't they wait until they are 6-8 weeks old like other immunizations?

The original rationale was simply timing the 3 injections in the series to fit in with normally scheduled newborn office visits. Dose #1 given at birth, dose #2 at 1 month of age, and dose #3 at 6 months meant that the shots coincided with regularly scheduled office visits.

For an infant of a Hep. B negative mom, there is no harm in delaying the initial vaccine, and many parents choose to do so.

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Specializes in Community, OB, Nursery.
For an infant of a Hep. B negative mom, there is no harm in delaying the initial vaccine, and many parents choose to do so.

And frankly, I'm glad to see it happening.

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I know this is off topic but why are we diving Hep B shots to newborns when we know Mom is Hep B negative? Why can't they wait until they are 6-8 weeks old like other immunizations?

It doesn't make any sense- the infants who receive the hospital dose are receiving 4 doses of a 3 dose series when they complete the immunization schedule. Makes me want to scream! If you check out the manufacturer's website it says there is no benefit to this practice. Most providers (at least in my area) are using COMVAX. Here is the info: (scroll down to page 15) http://www.merck.com/product/usa/pi_circulars/c/comvax/comvax_pi.pdf

The reason most often given is that the earlier you are given the Hep B vaccine, the more likely you are to seroconvert, however the above link even says there is no difference in seroconversion rates for those immunized at birth vs. two months.

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Specializes in Maternal - Child Health.
It doesn't make any sense- the infants who receive the hospital dose are receiving 4 doses of a 3 dose series when they complete the immunization schedule. Makes me want to scream! If you check out the manufacturer's website it says there is no benefit to this practice. Most providers (at least in my area) are using COMVAX. Here is the info: (scroll down to page 15) http://www.merck.com/product/usa/pi_circulars/c/comvax/comvax_pi.pdf

The reason most often given is that the earlier you are given the Hep B vaccine, the more likely you are to seroconvert, however the above link even says there is no difference in seroconversion rates for those immunized at birth vs. two months.

Do you mean that some babies are receiving 3 hepatitis b vaccines, and then an (unnecessary) 4th dose as part of Comvax?

If so why? Doesn't a separate hib vaccine still exist?

I can't understand why a reputable pediatrician would engage in this practice.

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The 4 shot series does make sense...if you are Merck. Parents need to be educated as to the issue of giving newborns an immunization at birth when they don't need it (providing mom is Hep B negative) and it can be delayed until their first set of imm. I refused to give my 12 hr old baby Hep. B 14 yrs ago and some of the staff was less than happy, judging by their looks.

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I'm told the reason for the birth recomendation is mostly compliance and simply, it's easier for the providers to mesh with the regular vax schedule. The state usually mandates the schedule anyway, atleast here.

I caught flack for not doing the newborn Hep B with my girls. They began vaccinating at 2 months, but didn't start with Hep B until 6 months. Now Hepatitis A is on the schedule for all children (here atleast) and I catch flack each check up for refusing that.

Such is life....

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Specializes in Ante-Intra-Postpartum, Post Gyne.
I know this is off topic but why are we diving Hep B shots to newborns when we know Mom is Hep B negative? Why can't they wait until they are 6-8 weeks old like other immunizations?

In my part of California we don't give any immunizations in the hospital, only Vit K and thats not really an immunization. They have the parents get them done at the pediatrician's office, besides, hep B is not legal required until Kindergarten. This is obviously not the norm thought the state because we had a traveling Pediatrician who was covering for one that was out of town ask where in the baby's chart he could find if the baby had his hep B yet. We told him that we do not given them in the hospital, he was surprised and said in his LA hospital they do. Surprisingly our small rural hospital is more progressive than the Big city.

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