Question
Do I need to increase the dose of NVP when baby gains weight?
29 January 2024. Related: Adherence, All topics, CD4 and viral load, Children, HIV transmission, PEP/PEPSE.
My baby is 1 month and I’m currently breastfeeding exclusively and my VL is undetectable. I was given nevirapine for 6 weeks and my dose was 1.5ml at the hospital. Now I know my baby has gained weight and I’m still giving the same dose. Will my child not be infected? Because I wasn’t told to change it of they gain weight and our next appointment is in 2 weeks.
Answer
Hi, how are you doing?
No you do not need to alter the dose. The dose of nevirapine is given based on the age of the person and not the weight.
How long have you been told to continue giving baby nevirapine for? As you are undetectable the risk of transmission is minimal and in these cases it is often recommended for baby to only be on nevirapine for 6 weeks.
Nevirapine is used to prevent infection from exposure in the tummy. Even if you are still breastfeeding there hasn’t been a benefit seen to continue with treatment after 6 weeks in low risk cases.
This is explained further here.
Josh.
Hi Nothando, it is great to hear baby tested HIV negative? Have you now switched to exclusive formula feeding?
After 6 weeks there is no additional benefit in baby continuing with nevirapine and zidovudine. This can now be stopped. Novatrim is an antibiotic used to prevent other infections that can be passed on through breastmilk. If baby is still breastfeeding they will need to continue with Novatrim and still have a second HIV test after breastfeeding stops.
If you are still breastfeeding, it is still a little young to be using 2 different types of feed. Before the age of 6 months baby’s tummy is still developing and switching between the two different feeds can irritate baby’s tummy increasing the risk of transmission. It is okay to switch from breast to formula.
More information about what treatment to give baby can be found here: https://i-base.info/qa/factsheets/infant-meds-when-the-mother-is-living-with-hiv
Hi,I hope you’re doing great
I was exclusively breastfeeding at ten week my baby was done PCR on the 14 weeks visit the results were nagative I was so exhilarated here is the thing before the visit I changed the feeding to formula I forgot to ask whether should I continue with the medicine or not my baby was on Neverapine,Zidovudine and Novatrim 1.5 ml a day please assist my clinic is too far