What is HIV?
HIV stands for Human Immunodeficiency (say: IM-you-noe-de-FISH-en-see) Virus. HIV is a virus that infects certain cells of the immune system. It makes the immune system weaker over time. This puts a person at risk of other serious infections.
People who are infected with HIV are called HIV-positive. People who are not infected with HIV are called HIV-negative.
Most children with HIV get it from their mothers who are also infected. HIV is passed to the baby during pregnancy, at birth, or through breastfeeding. If you are HIV-positive and having a baby, this page explains how to lower the risk that your baby will get HIV and how to find out if your baby is infected.
Your baby is less likely to get HIV if you have good care before, during, and after birth
All pregnant women or women who are considering pregnancy should have a test for HIV.
If a pregnant woman has HIV and does not receive medicine during pregnancy or delivery, the risk of infection for the baby is around 25%. This means 1 in 4 babies will be infected.
The risk that your baby will be infected with HIV is much lower if all of these things happen:
- You take medicine after the first 3 months of your pregnancy and have an undetectable viral load, meaning there are so few HIV viruses in your blood that they cannot be found in tests.
- During labour, you get a medicine called zidovudine (AZT) through an intravenous (IV) line. This means the medicine goes directly into your bloodstream through a vein.
- After being born, your baby takes AZT for 6 weeks.
If all these things are done, then the risk of infection to your baby is less than 1%. This means that fewer than 1 in 100 babies will be infected.
For more information, please read "HIV and Pregnancy."
Your baby will need tests for HIV
The doctor cannot tell if your baby has HIV just by looking at him. Most of the time, babies with HIV look the same as babies who do not have HIV. If a baby becomes sick with other infections, this could be related to HIV. It could also be an infection that would have happened to the baby anyway.
Tests for HIV
Your child's doctor needs to test your baby’s blood soon after birth and 2 more times, usually when your baby is 1 month old and 2 months old. The test is called PCR, which stands for Polymerase Chain Reaction. It looks for HIV in your baby's blood. It takes about 1 month to get the test results back. If the PCR tests do not find any virus, your baby is not infected with HIV.
For adults and older children, the regular HIV test is an antibody test. Antibodies are what the immune system makes to help fight off infections. When a child has an infection or receives a vaccine, his body makes antibodies against that infection. If someone has HIV antibodies in their blood, it usually means they have HIV. So the antibody test looks for HIV antibodies in the blood. Note that HIV antibodies do not protect against HIV.
The antibody test does not work for babies. When a woman is pregnant, she passes some of her own antibodies to her baby. This means that if a woman has HIV, the antibody test will always find HIV antibodies in her baby's blood, even if the baby does not have HIV. For this reason, your baby will need the PCR test instead to see if he has the virus in his blood.
Your baby will need to take AZT
When your baby is born, AZT will be started within the first day (24 hours) after birth. You will need to give your baby this medicine 4 times per day for the first 6 weeks of life. This will lower the risk that your baby will be infected with HIV.
A nurse or another health care professional will show you how to give the medicine.
Do not breastfeed your baby
If you have HIV, do not breastfeed your baby. Breastfeeding is one way of passing HIV from mother to child. In Canada and other developed countries, formula is the safest form of nutrition for your baby. There is a program in Ontario that provides free formula for the first year of life to babies born to HIV-positive mothers. Access the program by calling the Teresa Group. If you are outside Ontario, ask your health care provider about programs that provide free formula.
Your baby may have side effects from the medicines
Even if the HIV test is negative, the doctor will follow your baby to see if the drugs cause any short-term or long-term problems. The medicines given to pregnant mothers are very safe. A few short-term side effects can sometimes be seen.
- The AZT may cause anemia in your baby after birth. Anemia means your baby does not have enough red blood cells, the cells that carry oxygen to the rest of the body.
- AZT may also damage mitochondria and cause the baby to have problems with the blood or liver. Mitochondria (say: my-toe-KON-dree-uh) are found in all the cells in your body. They help make energy in the cell.
Any anemia or mitochondrial damage usually goes away once the AZT is stopped.
So far, studies suggest that taking these medicines does not lead to any major long-term effects. The studies also show that children exposed to these drugs are normal.
We will assess your child’s development on a regular basis. If any concerns are noted, we will make suggestions or will refer your child to other programs.
If your baby's HIV test is positive
In Canada, children with HIV can have healthy, normal lives if they go to clinic regularly for health care and take medicines as prescribed. If your baby is diagnosed early, the doctor can start medicines right away, if needed, to keep him healthy.
For more information, please read "HIV and Your Child."
HIV and pregnancy resources
If you have any questions or concerns, contact your child’s doctor or the HIV clinic.
For more information, please see the following:
Motherisk
www.motherisk.org
Teresa Group
www.teresagroup.ca
416-596-7703
Key points
- One in 4 babies of HIV-positive mothers will be infected with HIV if the mother does not receive medicine during pregnancy or delivery.
- Medicines for both the mother and baby can lower the risk of the baby also getting HIV.
- Your baby will need follow-up care to see if the medicines cause any side effects.