R.L.
Hi R.,
Lots of things can cause elevated liver enzymes, including malnutrition, inflammatory disease processes, and a variety of liver and blood diseases. Is your daughter jaundiced? Does she have unusual color (e.g., gray) or consistency of feces? Does she have dark urine? Does she seem unusually sleepy? Doe she have poor muscle tone (this can be difficult to tell with a 2 month old, but check her startle and grabbing reflexes to get an idea). If she has any of these symptoms, especially jaundice, check in with the doctor ASAP and ask for a more complete evaluation, including a recheck of the liver enzymes (ALT, AST and Alkaline phosphatase, especially). Depending on the results of these and other tests, your doctor may also want to do a liver ultrasound and/or a biopsy. More likely than not, however, there is nothing to worry about: the elevation could be transitory and a holdover from high neonatal bilirubin levels.
Not all babies are immunized against HBV at birth, although this is per CDC guideline and most hospitals are pretty diligent. Even so, only a portion of the viral surface protein is used to make the vaccine. While this will cause an immune response (usual symptom is fever), it should not cause elevation of the liver enzymes, as would happen if she actually had the disease. Elevation occurs because the liver is being damaged through the disease process.
Here's a caveat to the above -- is there any chance that you have chronic hepatitis B? If so, then you could have given it to your daughter at birth. Often, perinatal HBV vaccine will be sufficient to prevent infection of the newborn, but standard treatment is to also give immuneglobulin as well (HBIG). Also, is there any chance you have chronic hepatitis C? Again, if so you could have transmitted it to your daughter and the symptoms would be the same. Unfortunately, there is no vaccine for HCV, but infected infants can clear the virus without adverse effects. Please do not be insulted by this, but if you have ever engaged in high risk sexual activity, used injected drugs, or even had a blood transfusion before screening practices were instituted in 1992, you could be have contracted either HBV or HCV and never known it as many adults have either no or very mild symptoms.
I'm sure everything will be OK, but if you're concerned you should go seek the advice of your daughter's doctor, not nonmedical folks.
R.