The document discusses care for newborns exposed to HIV/AIDS, highlighting the risks of transmission during the perinatal period and the importance of zidovudine for prevention. It outlines diagnostic methods, nursing assessments, and management strategies to promote growth and minimize infections in affected infants, including nutrition, hygiene, and emotional support for families. Regular monitoring and timely administration of antiretroviral therapy are essential for the health of these infants.

1. CARE OF HIV/AIDS EXPOSED
BABIES

2. INTRODUCTION
• Increasing number of newborns are born infected
with HIV or are a risk for acquiring it in the early
infancy period.
• Transmission during perinatal and newborn periods
can occur ;across placenta, breast milk or
contaminated blood.
• The risk of transmission can be decreased if the
mothers take zidovudine during gestation.

3. Causes of mortality in HIV infected
babies:
Gram-negative sepsis
Prematurity
• Most infants infected by maternal-fetal transmission
suffer from severe immunodeficiency leading to rapid
progression of HIV especially during the first year of
life.

4. DIAGNOSIS:
1. Testing by HIV deoxyriboneucleic acid
(DNA) polymerase chain reaction(PCR) is the
most preferred test (DNA-PCR). Results are
available within the first 24 hours.
2. Viral culture, but is more expensive.
DNA PCR test is repeated when the infant is 1
month of age.

5. • NB; DO NOT USE UMBILICAL CORD BLOOD
FOR TESTING HIV.
3. p24 antigen test. Can be used if PCR or Viral culture
test are unavailable. It assesses HIV infection status in
infants older than 1 month. But it is less sensitive than
the others.
For infants with 3 negative- at birth, at 1 month and at 4
months of age are further tested using ,4. Virologic
antibody tests and 5. Negative –specific IgG assay
(ELISA) at 18 months of age to rule out HIV in exposed
infants.

6. AZT(zidovudine ZDV) is started prophylactically
2mg/kg/dose PO in every 6 hours ie 4 times a day.
• If the infant is confirmed to be HIV positive, change
the ZDV to ANTIRETRIVIRAL regimen.
.

7. NURSING CARE MANAGEMENT:
Nursing assessment and diagnosis;
• Most newborns exposed to HIV/AIDS are
premature and therefore show failure to thrive.
SIGNS AND SYMPTOMS include:
• Splenomegaly and Hepatomegaly.
• Swollen glands.
• Recurrent respiratory tract infections

8. • Rhinorrhoea.
• Interstitial pneumonia
• Diarrhea and weight loss.
• Urinary system infections.
• Recurrent oral and genital candidiasis.
• Loss of developmental milestones.

9. NURSING DIAGNOSES;
1. Altered nutrition less than body
requirement related to inadequate intake.
2. Risk for impaired skin integrity related to
chronic diarrhea.
3. Risk for infection related to perinatal
exposure to HIV/ AIDS.
4. Impaired physical mobility related to
decreased neuromuscular development.

10. IMPLEMENTATIONS:
Use standard precautions when caring for the
newborn immediately after birth till all maternal
blood is removed.
• Keep babies well nourished and protected from
opportunistic infections to facilitate growth and
development.
• Wear gloves when changing and cleaning diaper
area especially in presence of diarrhoea coz blood
may be in the stool.
• Skin care to prevent rashes.

11. Home based care;
1. Hand hygiene before handling a newborn at risk of
AIDS.
2. Proper nutrition to avoid failure to thrive and weight
loss. Weigh the baby 3times a week
3. Health education on signs of feeding intolerance e.g.
increasing regurgitation, abdominal distension, loose
stool as well as of infection especially oral thrush.
4. Administer fluids and antipyretics to manage fever.
Irritability is the first sign of fever.
5. Administer topical mycostatin for diaper rashes and
oral mycostatin for oral thrush.
6. Baby should have his or her own skin care items e.g.
towels, soap, washing clothes.

12. 6. Routine immunization but avoid the live polio vaccine.
7. Keep toys as clean as possible and free from sharp
edges.
8.Emotional support for the family coz of the stress and
social isolation.
9. Parent should hold the baby gently during feeding.
10. The nurse should offer information to the family
about support groups, counseling and information
resources.
11. Provide therapeutic information about HIV disease to
the family.

13. 12. Infants of infected mothers are given ARV drug therapy
such as Zidovudine(AZT) beginning 8-12 hours of life till
6 weeks.
13. All infants born of HIV-infected mothers require
regular clinical, immunologic and virologic monitoring.
At 1 month, they are done physical exam + developmental
assessment, compete blood count including: CD4+ count,
platelet count.
14. Prophylaxis for pneumonia should be adm to all infants
born of HIV –infected women, 4-6 weeks of age regardless
of their CD4+ lymphocyte count

14. …
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