Am Fam Physician. 2021;104(1):online
See related article on management of infants born to mothers with HIV infection
What is HIV?
HIV is the virus that causes AIDS. It is possible to have HIV infection for a long time before developing AIDS.
How can my baby get HIV?
A mother with HIV infection can pass it to her baby during pregnancy, at childbirth (also called labor or delivery), or by breastfeeding (through her breast milk). Most babies who get HIV from their mothers become infected at childbirth. However, not all women with HIV know that they are infected. All pregnant woman should be screened for HIV with each pregnancy.
If you have HIV infection, there is a 1% to 30% chance that you will pass HIV to your baby. The amount of risk depends on your health and what you do to keep your baby from getting HIV.
What can I do to keep my baby from getting HIV?
If you have HIV infection or AIDS, you can lower the risk to your baby.
Take HIV medicine as prescribed to protect yourself, your partner, and your baby. HIV medicines can help lower your chances of giving HIV to your baby.
Work with your doctor to keep your baby from being born early. If the amount of virus in your blood is not low enough, a cesarean delivery (c-section) can also help to stop passing the virus to your baby. Don't breastfeed your baby because HIV can spread to your baby in your breast milk. Use formula instead.
Give your baby a medicine called zidovudine (also called ZDV; brand name: Retrovir) twice a day from birth until six weeks of age.
Do not prechew your baby's food.
Talk to your doctor before you start trying to get pregnant. See your doctor regularly as soon as you think you might be pregnant.
How is my baby tested for HIV?
Your baby will have a blood test for HIV within a few hours after birth. This test is done again when your baby is 14 to 21 days old, one to two months old, and four to six months old.
If two or more blood tests show no HIV infection in your baby's blood, your baby is most likely not infected. However, one last HIV test is done when your baby is older than 18 months. Until then, your doctor will check your baby often for signs of HIV infection. If one HIV blood test is positive, your doctor will do the test again.
Is my baby more likely to get other illnesses?
Babies who get HIV might also get other illnesses, like hepatitis B, hepatitis C, and tuberculosis. During your pregnancy, it is important for you to be tested for these diseases. If you have any of them, your baby will also be tested for them at birth.
Babies with HIV are more likely to get lung infections. One is a type of pneumonia called PCP. Sometimes a baby gets PCP even before a blood test shows that the baby has HIV infection.
All babies born to a mother with HIV should take an antibiotic once they are four to six weeks old to prevent PCP unless their first two HIV tests are negative.
What doctor visits does my baby need?
Just like other children, babies of mothers with HIV infection need regular check-ups. Your doctor will measure your baby's growth and development, check for infections, and answer your questions.
Your baby will also get most of the same shots (vaccines) that other babies get. Check with your doctor about when your baby needs to get vaccines.
Also, talk with your doctor about what to do when your baby gets sick. In general, you should call your doctor if your baby:
Has a rectal temperature higher than 100.4°F (38°C)
Gets a rash
Has trouble breathing
Has vomiting or diarrhea for more than 24 hours
Where can I get more information?
Your doctor
Your state and local health departments
Centers for Disease Control and Prevention
1-800-232-4636
National Institutes of Health—HIVinfo
1-800-448-0440
TheBody, The HIV/AIDS Resource
U.S. National Library of Medicine—MedlinePlus
