What every pregnant woman should know about HIV and AIDS

1. What every pregnant woman should know about HIV and AIDS Are you pregnant?

2. A mother can pass HIV to her baby through pregnancy, labour and delivery, or breastfeeding Not every mother who is HIV positive will pass the virus to her baby. We CAN Prevent it!

3. Risks are higher if: Mother has full blown AIDS Has high viral load Gets reinfected when she is pregnant or breastfeeding Has many sex partners Does not eat well and her body is weak Has an untreated STI We CAN Prevent it! Go with your partner for ANC as soon as you know you are pregnant All pregnant women should be tested and counselled with their partners

4. If you or your partner is HIV +, you can still protect your baby and the mother’s health. If both of you are HIV+… If one of you is HIV+… Continued sex in pregnancy is good, use a condom to prevent reinfection Both you and your partner need support. Find someone you can trust to tell about your HIV status, so that they can support you both during your pregnancy, delivery, and feeding. Ask about support groups for mothers and PLWHAs…..(benefits)

5. Your strength and well being is very important to keep the HIV virus low in your body. What you should do… Nutrition for HIV + Mothers is very important!

6. Where will you deliver? With who? Who will come with you to the hospital? What transport is available if there is an emergency? Know the danger signs in pregnancy…. What you should bring with you to the hospital… 4 clean chintenches…. Plan for your wife’s safe delivery and arrival

7. Did you know that the risk of transmission of HIV during labour and delivery is very high? HIV can pass through small cuts and wounds which occur to the mother or baby as the baby is being born. Special risks: When labour is delayed When labour is long When there are many examinations of the vagina When the mother delivers under the care of person who is not trained. Protecting your baby during labour and delivery

8. Deliver with a trained provider at the hospital (they have the knowledge and support you need) Take neviripine at the onset of labour to slow the growth of HIV in the body and reduce the chances of the baby getting HIV. Do not take traditional medicine to induce labour. This can cause rupture of the uterus. Avoid early pushing which can cause the bag of waters to break early and make cuts in the birth canal and on the baby Get a trained birth attendant to support your during labour and delivery What can you do?

9. Come back to the health centre within three days so that your baby receives neviripine to prevent HIV. During the visit you will also be checked to be sure that you are healing properly from the delivery and that your baby is alright. Know the danger signs after delivery for you and your baby!!!! Protecting your new born baby from HIV.

10. Exclusively breastfeed your baby for six months without given any other foods, water, or traditional mankhwala. Other foods damage the inside of the baby’s intestine and make it easier for HIV to get into the baby’s blood. It also makes it more difficult for the baby to breastfeed as much as it needs/and for the mother to continue to produce. Offer the breast within the first 30 minutes after delivery. The first milk is very important to the baby’s growth (it contains all the nutrients….) Remember: Continue to use condoms to prevent reinfection of the mother and new HIV to the baby. Discuss with your provider how to safely feed your new baby to prevent HIV transmission

11. Keep the breast clean (Note any cuts, sores…etc.) which are present Come back to the HC as soon if you have any problems or see any signs of infection for you or your baby. Make sure that your immediate family is also aware that no other foods should be given so that they can support you in keeping your baby healthy. Not every woman, regardless of her HIV status, will be able to breastfeed her baby because of different reasons: For these women, there are other feeding options which she can choose with her partner after counselling by a trained provider The most important thing is that every baby must be fed only that method until six months to reduce risk of HIV infection. The feeding method must be acceptable, always available, always clean and safe.

12. Getting started…. Breast milk has all the nutrients (food and water) your baby needs to grow and develop. Other foods can damage the baby’s intestines and make it easier for HIV and other infections to get into the baby’s blood Put the baby on the breast well to make sure that the baby does not pull and crack the nipples… He should latch so that the nipple and aereola are inside the baby’s mouth. Sucking stimulates milk (at least 10-20 minutes on each breast) Breastfeed whenever the baby wants to feed day or night. (At least 8-12 times a day). Wake up the baby if it is sleeping too long to make sure it feeds. The more you feed your baby, the more milk you will produce. What happens if I don’t have enough milk? Almost all women can produce enough milk for their babies growth…. What happens if I need to go away? If you are going away for a long period, express milk into a cup and leave it behind to be given to the baby with a spoon. The cup and spoon must be clean to make sure that no germs can enter the baby’s body. (Ask Mwate) Your nutrition! It is very important that you eat a variety of foods at least three full meals, small meals in between, and lots of liquid. Good foods include pumpkin leaves, squashes, etc. (high in vitamin A) Different feeding positions, attaching the baby…. How to breastfeed your baby….

13. Transition period Just before six months…., breastfeed the baby part of the time, and express breast milk at other times. Give by cup and spoon. This will help the baby to get used to feeding by cup and spoon. Stop breastfeeding completely before you start giving the baby other milks or foods??? Introducing complementary foods safely. Introducing complementary foods safely.