11.09 Newborn of HIV+ Mother

Overview

1. Close monitoring of HIV+ pregnant women is essential
2. Current recommendations are for HIV+ mothers to not breastfeed because of transmission risk

Nursing Points

General

1. Ongoing assessment of the newborn up to 18 month after birth is necessary, as mother’s antibodies persist that long
   1. Lab tests
2. Modes of transmission
   1. Across the placenta during pregnancy
   2. During childbirth
   3. Through breastmilk

Assessment

1. Asymptomatic at birth
2. Immunodeficiencies
3. CBC with differential (CD4 count)
4. Blood test for HIV

Therapeutic Management

1. Interventions
   1. Antiretrovirals
      1. AZT (zidovudine)
   2. Watch for signs of immunocompromise (enlarged liver or spleen)
   3. Immediate bath
   4. Lab tests
      1. HIV testing
         1. Unreliable until around 18 months because of maternal antibodies

Nursing Concepts

1. Immunity
2. Infection control
3. Lab values

Patient Education

1. Guidelines for breastfeeding
2. Guidelines for vaccinations
   1. No live vaccines until it is confirmed that there is no HIV
3. Importance of follow-up and testing