Prevention of tuberculosis in a child begins even before its birth. Pregnancy has a suppressive effect on the cellular immune response and reactivation of old tuberculous foci can occur — therefore, this period is a period of risk of tuberculosis in women. To prevent the penetration of tuberculosis into the family, it is necessary to conduct LFF for the first 6 months of pregnancy for all persons who will live in the same apartment with the child and those in contact with it.
When a patient is identified, together with a phthisiatrician, the issue of hospitalization in a hospital, the final disinfection before the child is discharged from the hospital is decided. If hospitalization of the patient is impossible, then the issue of delaying a healthy woman and a vaccinated child for 45 days in the maternity hospital (until immunity is developed) is resolved. If it is impossible to separate contact with a diseased person discharging bacteria, then a newborn child is prescribed chemoprophylaxis from the beginning of contact. After giving birth, the mother must undergo a fluorography within a month.
Tuberculosis and motherhood. Children born to mothers with tuberculosis are usually healthy. Most babies become infected after birth through contact with their mother.
The maternity ward must be notified in advance that a woman has tuberculosis, she is placed in a separate block. After discharge, the final disinfection is carried out.
A newborn child from a mother with an active form of tuberculosis, regardless of the allocation of MBT, is vaccinated with BCG at birth in the maternity hospital. The child is completely isolated from the diseased mother for at least 8 weeks, for which the newborn is placed in a specialized department or (according to indications) the child is discharged home to relatives. If the newborn was in close contact with a diseased mother before the introduction of the BCG vaccine (birth of a child outside a medical facility, etc.), vaccination against tuberculosis is not carried out. The child is prescribed a course of chemoprophylaxis for 3 months, and only after that, with a negative reaction to the Mantoux tuberculin test with 2 TU PPD-L, they are vaccinated with the BCG-M vaccine. If the mother of a newborn is diagnosed with tuberculosis after the BCG vaccine has been administered and this was not known to the tuberculosis dispensary, prophylactic treatment for the child is carried out regardless of when the BCG vaccine was administered. Such children are under close observation by the district health department as the group most at risk for tuberculosis.
If a mother with tuberculosis does not excrete mycobacteria and receives antibacterial drugs, contact with the child is not separated, the child is vaccinated, chemoprophylaxis is not prescribed (because the child receives antibacterial drugs with milk).
For newborns vaccinated in the maternity hospital with the BCG vaccine from mothers with tuberculosis, in whom it was not detected in a timely manner, and who fed the child with milk, it is necessary to observe together with a phthisiatrician and prescribe chemoprophylaxis.
When feeding with milk, it is important to prevent its contamination from infected cattle. If a nanny is hired, she needs to undergo a broad-format fluorography, especially for elderly people.