Breastfeeding/expressed breast milk (EBM) is not recommended if mother is known HIV positive, regardless of maternal antiretroviral therapy and/or viral load due to the risk of transmission to the infant
Universal precautions for blood and body fluid: wash injection site prior to IM injection or blood sampling
Low Risk Situations
Mother must meet ALL criteria:
On combination antenatal antiretroviral therapy with optimal adherence
HIV viral load <40 copies/mL within 4 weeks of delivery
Consistent prenatal/HIV care
Moderate Risk Situations
Moderate risk: Mother received antenatal antiretroviral drug therapy but HIV viral load >40 copies/mL near delivery (known or projected)
High Risk Situations
High risk: Mother did not receive antenatal antiretroviral therapy in pregnancy
Laboratory
Infant Diagnostic HIV PCR - Send 2mL in one EDTA tube (lavender top), PHSA Lab Serology Screening Requisition #00073506 Request Infant Diagnostic HIV PCR under Other Tests
Complete blood count (CBC) with differential
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Bilirubin, total unconjugated and conjugated
Urea
Creatinine (Cr), serum
Saliva Swab CMV
Questions and Consults
Oak Tree Clinic staff (604-875-2250) are available to provide telephone advice Monday-Friday 8:30-16:30 (leave message if after hours)
After 16:30 and on weekends, contact BC Children's Hospital (604-875-2161) and ask for the Pediatric Infectious Disease specialist on call
Additional Resources
Pre-printed order sets
Guide for interpreting test results
Oak Tree Clinic website
