Importance of Mother to Child Transmission - By: Sandra Olivier

It is a common misunderstanding that pregnant women who are HIV-positive will automatically pass the disease to their babies. This is not true. Only one out of every three children born to HIV-positive mothers will become infected with HIV disease. In other words two out of every three babies will be born healthy.

With an appropriate PMTCT programme this risk can be reduced substantially so that less than 5% of babies become infected via their mothers. PMTCT is one of the most crucial issues in the current struggle against HIV infection. Thousands of babies are becoming infected unnecessarily, causing much suffering and further stretching limited health facilities.

It is therefore important for all women with HIV disease who become pregnant to enrol in the PMTCT programme and reduce the risk of transmitting the disease to their unborn children. Woman should have a HIV test if she doesn't know her status when she falls pregnant. If she tests negative she can continue to make sure she stays negative by practising safe sex at all times. If she tests positive she can enrol in the programme and find out how to protect her child from getting the disease. It is important that she continues to practise safe sex at all times too.

This will protect her partner if he is HIV-negative. If he is also HIV-positive it will protect her from being exposed to additional viruses.

How HIV disease is passed from mother to baby There are three ways in which mother-to-child transmission of HIV disease can occur:

-In the womb. Disease transmission seldom occurs this way as the baby is protected in a bag containing amniotic fluid and the mother's blood and baby's blood never come into direct contact

-During labour and delivery. The majority of babies (60-85%) are infected during or immediately after delivery. The risk of infection increases as soon as the waters break and when the afterbirth comes away from the womb

-After birth, through breastfeeding. Breastfeeding accounts for approximately 15% of mother-to-child transmission cases. This percentage is reduced if the mother breastfeeds exclusively and if she breastfeeds for a shorter period. The risk of transmission remains constant throughout the period of breastfeeding period; it is not higher at the beginning. The risk will increase to around 30% if a mother has been very recently infected, or if she has advanced HIV disease. This because the mother has a much higher viral load (number of viruses in her body) during the very early and late stages of HIV infection. This means there will be more viruses present in the breast milk

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