Care of neonates

Babies of HIV positive mothers should be handled with gloves until maternal blood and secretions are washed off, after which time they can be handled safely by mothers and health workers. Anaemia has been the most common complication seen in the neonate with the long-course treatment of six weeks ZDV to the child. Haemoglobin should be measured at baseline and after six weeks and 12 weeks if this regimen is used. The anaemia risk is much less with the short-regimen. Infants receiving long-course antiretrovirals may experience a transient elevation of hepatic transaminases.

There is less experience with the use of combination therapy in the pregnant mother and the risk of toxicity to these infants, and more intensive haematological monitoring would be advised.

Mothers should decide on infant feeding practice before delivery and be supported in their choice. Children should be referred for long-term follow-up and for repeat testing for diagnosis of HIV infection, either by early PCR if available, or by ELISA at 15 to 18 months.