Question
My baby is on nevirapine and I’m breastfeeding, is my baby positive?
19 August 2016. Related: All topics, Pregnancy.
Answer
Firstly, congratulations on having your baby.
It is normal for your baby to be given a short course (4 weeks) of HIV treatment (such as nevirapine) when born. This doesn’t mean your baby is HIV positive. This will be checked later through testing. A different type of testing is also used on babies as the normal antibody test used in adults will show the baby as positive.
Our guide on pregnancy has lots more information
https://i-base.info/guides/pregnancy
In the UK, the BHIVA (British HIV Association) guidelines recommend bottle feeding.
This is because in countries where mothers can have access to to formula milk AND clean water AND bottle sterilising equipment, the risk of transmitting HIV to the baby through bottle feeding is zero. There are different recommendations for other countries though and many women breastfeed. I am not sure about the recommendations in Zambia.
This means that you are doing the best that you can to protect your baby.
However, being positive and looking after a new born baby can be hard and many people need help. Do you have much support around you to help or are you touch with good care from your doctor?
Hi,
I’m HIV+ for 7 years now and my viral load is lower than detectable. I have just given birth to a girl, 7 days old now. She has tested negative & is on NVP and will be taking it for 6weeks.
I am using formula only as a feeding option, will it be okay to give baby water once in a while to hydrate since she is on formula? Or mix the water with glucose?
Hi Anelisa, congratulations on having a baby. How high is your viral load? and are you on treatment?
With a detectable viral load it would be advised to only formula feed. It is good that baby is on nvp – this will help to reduce the risk of transmission. Having a detectable viral load does mean there is an increased risk of transmission via breastfeeding. This risk will be eliminated if you are able to only formula feed.
Hi my baby is 2 weeks old and on nvp
My viral load is high and detectable
Is it safe for me to be breastfeeding, I’m scared of transmitting to him
Should I just formula feed instead
Hi Palesa, congratulations on having a baby. How high is your viral load? A viral load below 200 is still considered undetectable. Even being slightly higher than this the risk will be greatly reduced by even being on treatment. Do you know what your CD4 count is?
As you have been on established treatment for the last 2 years and baby is taking their own medication, you have made sure the risk of transmission is as low as possible. You are doing everything correct. In these cases the risk of transmission to baby is less than 1%.
Hi my baby is on nevirapine am breastfeeding started hiv treatment 2years ago my hiv is detectable does that mean my baby is affected
Hi Victory, congratulations on having a baby. No this does not mean baby will become resistant to NVP.
Is there a reason that baby is still taking NVP?
It is often recommended that baby stop between 4 and 6 weeks as there is no further benefit to continue treatment, even when breastfeeding. It will not lead to resistance if baby continues treatment.
My baby is on NVP for 16 wks will he become resistant to it as normal dose is 4-6wks
Hi Thembi, congratulations on having a baby. It is great that baby is taking NVP.
Unfortautnely it isn’t recommended to mix feed until baby is at least 6 months. Changing between feed types can irritate baby’s tummy and before 6 months their tummy is still developing. This irritation can then cause an increased risk of HIV transmission.
Would you be able to express milk so you can bottle feed breast milk when you are not at home?
Hi my baby is amost 6 weeks she is in NVP can use formula milk n breastfeeding cause am working coming home late at night?
Hi Alisha, congratulations on having a baby. It is great that you are undetectable, this makes risk of transmission as low as possible.
Recommendation for baby to be on nevirapine to a mum who is HIV negative is usually around 4-6 weeks. Stopping a week early due to being unable to access more is unlikely going to have a significant impact on transmission. Are you exclusively breastfeeding? Switching between breast and formula feed can increase the risk of transmission.