Information for pregnant women who have HIV
I am HIV-positive and pregnant. Will my baby get HIV?
Your baby may get human immunodeficiency virus (HIV) from you during pregnancy, during delivery or from breastfeeding. However, there are ways to significantly reduce the chances that your baby will become infected.
How can I protect my baby from getting HIV?
During your pregnancy and delivery, you should take antiretroviral drugs (used to treat or prevent HIV) to lower the risk of passing the infection to your baby – even if your HIV viral load is very low. If you and your baby do not take antiretroviral drugs, there is about a 1 in 4 chance that your baby will get HIV.
Your baby should take one or more antiretroviral drugs for the first 4 or 6 weeks of life. If you and your baby take every dose of the drugs, the chances of your baby getting infected with HIV drops to below 1% (1 in 100).
Should I deliver my baby by Caesarean section?
The best way to deliver your baby (by Caesarean section or vaginally) depends on how much of the virus is in your blood (your HIV viral load) at the time of delivery. Your doctor can give you advice on what is right for you. If your viral load is high, your doctor will likely recommend a Caesarean section to prevent your baby from getting HIV during labour. If your viral load is low, your doctor will probably recommend a vaginal delivery unless there is some other reason why you need a Caesarean section.
Will antiretroviral drugs hurt my baby?
We have used these drugs during pregnancy and in newborn babies for over 20 years. So far, children exposed to these drugs during pregnancy and as babies haven’t had major problems in infancy and childhood. But it is still too early to tell whether there may be late effects as children become adults.
When will I know whether my baby is HIV-positive?
Blood tests, like those that determine your HIV viral load, can detect if your baby has HIV. Usually three blood tests are done:
- Within the first few days or weeks after birth
- At 1-2 months of age
- At 4-6 months of age
If these 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 2 years of age.
What if my baby is infected?
If any of the tests come back positive, another test is performed as soon as possible to find out whether your baby is infected with HIV. If your baby is infected, treatment with antiretroviral drugs should start and continue indefinitely. These drugs may be different from the drugs given in the first 4 to 6 weeks. Treatment is effective, safe, and will help keep your baby healthy.
Can I breastfeed my baby if I am HIV-positive?
We recommend that your baby get an iron-fortified infant formula instead of breast milk as the baby could get HIV from breast milk. If you decide to breastfeed, it is very important that you discuss this with your HIV doctor and your baby’s doctor. They may want to change the type of antiretroviral drugs that you or your baby are given or may give them to your baby for longer than 6 weeks.
Should my baby get the same vaccines as other babies?
Yes, your baby should get the same vaccines as other babies. The only exception is BCG, a vaccine against tuberculosis, which is occasionally given to newborns if there is an outbreak of tuberculosis in the area.
Should my baby be seen by an HIV specialist?
Usually yes. However, if you live far from a big city, your doctor should check with someone who specializes in HIV in children to find out what medicine to give your baby and what blood tests to do. It may be possible to have the blood tests done at your closest laboratory.
More information from the CPS:
Reviewed by the following CPS committees:
- Infectious Diseases and Immunization Committee
Last Updated: February 2017