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Information for pregnant women who have HIV

I am HIV-positive and pregnant. Will my baby get HIV?

Babies can get human immunodeficiency virus (HIV) from their mother during pregnancy, during delivery (the most common way babies get infected), and through breastfeeding. However, most babies will not get HIV.

How can I protect my baby from getting HIV?

Without treatment, your baby has a 1 in 4 risk of getting HIV. But there are things to help reduce the risk. During your pregnancy and delivery, you can take antiretroviral drugs (used to treat HIV) to lower the risk of passing the infection to your baby. If you take these drugs during pregnancy and delivery and your newborn baby also receives them, the chance your baby will be infected with HIV can drop as low as 1% (1 in 100).

Should I deliver my baby by Caesarean section?

How you deliver your baby (by Caesarean section or vaginally) depends on how much of the virus is in your blood at the time of delivery. Your doctor can give you advice on what is right for you.

If you are not taking any medicine for HIV, it’s better to deliver your baby by Caesarean section.

If you are taking a combination of drugs and the amount of virus in your blood is undetectable (so low that it cannot be found), there is no clear advantage for a Caesarean delivery compared with a vaginal delivery to prevent your baby from becoming infected with HIV.

Will antiretroviral drugs hurt my baby?

Antiretroviral drugs have been used to prevent infants becoming HIV infected since 1994. All drugs can have side effects in some people and so all babies are watched to ensure that they can take the medications.

So far, children exposed to these drugs during pregnancy and as babies haven’t had major problems in infancy and childhood. It’s still too early to tell whether there may be effects as children become adults.

If you have questions about taking HIV drugs during pregnancy, you can call The Motherisk HIV Healthline 1-888-246-5840.

When will I know whether my baby is HIV-positive?

Blood tests, like those that determine your HIV viral load can tell if your baby has HIV. Usually three blood tests are done:

  • Within the first few days or weeks of your baby being born;
  • At 1 month of age; and 
  • At 2 months of age.

If all three tests are negative for HIV, your baby doesn’t have the virus. Many doctors will confirm this by testing your baby for HIV again at around 1 year of age.

If any one of the tests done in infancy is positive, another test is performed. If two tests are positive, then your baby is infected with HIV.

Can I breastfeed my baby if I am HIV-positive?

No. Your baby can get HIV from your breast milk. You should give your baby an iron-fortified infant formula as a safe alternative to breast milk.

Will my baby need any extra medicine?

Yes. Your baby should take an antiretroviral drug called zidovudine (which is given in a syrup) for 6 weeks after birth. It will provide extra protection against HIV infection.

Should my baby get the same vaccines as other babies?

Yes, your baby should get the same vaccines as other babies.

Should my baby be seen by an HIV specialist?

Your doctor should check with someone who specializes in HIV in children to make sure that you get the information and services you need. Most HIV specialists are part of a team of health care workers (doctors, nurses, social workers, dieticians, pharmacists, physiotherapists and occupational therapists) that can be a useful resource for you.

More information from the CPS:

Reviewed by the following CPS committees:
Infectious Diseases and Immunization Committee

Last Updated: June 2008