After the baby is born

Your own adherence after the baby is born is critical. Babies born to HIV-positive mothers will always test HIV-positive at first, because they have their mum’s immune system and share her antibodies. If your baby is not infected with HIV these will gradually disappear.

What will I need to consider for my own health?
How and when will I know that my baby is HIV-negative?
Will my baby need to take HIV drugs after he/she is born?
Will I need to use contraception after the baby is born?

What will I need to consider for my own health?

Mother and sleeping child Adherence!

This means taking your drugs exactly as prescribed. Your own adherence to your HIV treatment after the baby is born is critical.

Many women have excellent adherence during their pregnancy.
After the baby is born, however, it is easy to forget your own health.

This is hardly surprising. Having a new baby can be a huge shock and is always unsettling. Your routines will change and you are unlikely to get enough sleep. In serious cases, women can have postnatal depression.

You will need lots of extra support from your family, friends and healthcare team. You may also find a community group very helpful.

Many mothers find the best way to remember to take their own medication is if they link it to the dosing schedule of their new baby. So if your baby has two doses a day and you have two doses, make sure that they are taken at the same time.

Adherence charts and tips to help with adherence.

The i-Base booklet Introduction to Combination Therapy has tips to help you with adherence.

How and when will I know that my baby is HIV-negative?

Babies born to HIV-positive mothers will always test HIV-positive at first. This is because they have their mum';s immune system and share her antibodies. If your baby is not infected with HIV these will gradually disappear. This can sometimes take as long as 18 months.

The best test for HIV in babies is very similar to a viral load test. Called an HIV PCR DNA test, it looks for virus in the baby's blood rather than at immune responses.

Good practice in the UK is to test babies:

the day they are born
when they are 1 month old
when they are 3 months old

If all these tests are negative, and you are not breastfeeding your baby, then your baby is not HIV-positive.

You will also be told that your baby no longer has your antibodies when he or she is 18 months old. This exciting milestone is called seroreversion.

To check the baby is HIV negative…

HIV PCR DNA – a polymerase chain reaction (PCR) test is a highly sensitive test that detects tiny amounts of HIV DNA in blood plasma.
The test will "amplify" or multiply the DNA so that it can be more easily detected.

Will my baby need to take HIV drugs after he/she is born?

Your baby will need to take HIV drugs for probably four to six weeks following his or her birth.

The most likely drug will be AZT, which must be taken either two or four times a day. In a few cases your baby may be given another drug or combination therapy if you are resistant to AZT.

As we suggested earlier, try and co-ordinate the baby’s prophylaxis treatment with your own treatment schedule.

Will I need to use contraception after the baby is born?

You will be given advice on contraception after your baby is born.

It is possible that resuming or beginning oral contraception will not be recommended if you began using anti-HIV drugs in pregnancy. This is because some HIV drugs can reduce the levels of some oral contraceptives, which means they would not be foolproof birth control.

Please make sure your doctor knows about this and can advise you.