2.3. How do I protect my baby from HIV infection (PMTCT)?

* Women who are HIV positive and pregnant can pass the HIV virus to their babies during pregnancy, labour, delivery and breastfeeding. This can be very hard to cope with, especially if you only find out you are HIV positive when you are already pregnant.
* All women who are pregnant should have an HIV test so they are able to make decisions about the best way to prevent transmission to their unborn baby.
* It is important to remember that nobody can force you to take the test. HIV testing must be voluntary, confidential and accompanied by counselling.
* There are many benefits of having an HIV test when you are pregnant.
* If the HIV test result is negative you will receive:
- HIV prevention education to keep you HIV negative.
- Information about how to maintain a healthy pregnancy.
- Regular tests to make sure you give birth to a healthy baby.
- Information regarding family planning after the pregnancy.
* If the HIV test result is positive, you will receive:
- Counselling immediately following the result and then ongoing sessions.
- Prevention education to avoid re-infection. There is more than one strain (type) of HIV and it is more difficult to manage your HIV status if you are re-infected with another strain.
- Counselling to help you decide if you want to terminate the pregnancy (have an abortion). If you choose to do this, the clinic must refer you to a health facility that offers this.
- Advice on how to manage your HIV status during the pregnancy and when the baby is delivered.
- Clinical care for any HIV-related illness e.g. TB or pneumonia.
- Information on different ways to prevent passing the virus to the unborn baby. This is known as the Prevention of Mother-to-Child Transmission or PMTCT.
- Counselling about whether or not to breastfeed.
- Family planning after the pregnancy to prevent future unwanted pregnancies.
- Appropriate care for HIV and AIDS.
What choices are open to pregnant women living with HIV?
* Take Neviripine/AZT during labour
HIV positive pregnant women should be treated with either Nevirapine and/or AZT. The treatment that is prescribed for you will depend on a number of different factors. It is important to note that whichever treatment you are offered, you will be protected from passing the HIV virus to your unborn baby. You will be given either Nevirapine and/or AZT when you start labour to prevent the transmission of HIV to your baby. Your baby should also be given a small amount of Nevirapine within 3 days of the birth. Babies take it in syrup form so it is easy for them to swallow. Ask your health worker for more information.
* Caesarean-section birth
There is a bigger chance that HIV will pass from a mother to her baby in natural childbirth than in a Caesarean-section birth. Speak to a health worker about your options.
* Feed the baby with care
Even if you have taken Neviripine, you can still pass on HIV through breastfeeding. There are things you can do to try stop HIV from being passed on to your baby. Women living with HIV will be encouraged to either breastfeed or formula feed but not to use both types of feeding at the same time as this creates the risk of HIV transmission:
1. Breastfeed only for 6 months
- Don't give your baby any other food or drinks (not even water) until he or she is 6 months old.
- Other food and drinks are hard for babies to digest before they are 6 months old. They may cause tiny cuts in the baby's stomach. These cuts make it easier for HIV to get from the breast milk into the baby's body,
- Many babies get sick or die from diarrhea-related illnesses caused by the germs in water or bottles that are not properly sterilised.
2. Feed with milk formula only
- If you can afford it, feed your baby with milk formula. Some clinics provide free formula - find out about this.
- Mix the formula with water that has been boiled for a few minutes to kill any germs. Let the water cool before you use it.
- Measure the water and mix in the correct amount of formula powder. Follow the instructions on the tin.
- Feed the cooled milk to your baby with a cup and spoon or in a bottle. Make sure the cup and spoon or bottle are clean. Scrub them and then boil them 10 minutes before you use them.
- Germs grow in milk, so even if you can't see any dirt, boil your baby's bottles.
- If there is no clean water where you live, it is better to breastfeed your baby for six months.
Talk to a healthworker in your local clinic to find out more about each of these choices.


NOTE! Read more about HIV and AIDS by following the menu on the left.