Postnatal Prophylaxis (PNP) medication to reduce the chance of infection in your baby

What is PNP medication?

PNP, or post-natal prophylaxis is a course of medicine given to your newborn baby to reduce the risk of infection. Important factors the medical team will consider when prescribing this medicine will be specific to your pregnancy and treatment, and the stage of pregnancy when your baby was born. Depending on these factors, babies will be classified as low risk or high risk.

What medicines will be prescribed for my baby?

Depending on the factors above, the following medicines will be prescribed:

• Medication: Zidovudine
  Risk: Low risk
  Duration: 2 weeks
• Medication: Combination of 3 medicines
  Risk: High risk
  Duration: 4 weeks

The most common medicine prescribed for newborn is Zidovudine, also known as AZT.

What are the common side effects with zidovudine?

Zidovudine has been given safely to thousands of newborn babies. Like any drug it can have some side effects. In the babies we have given it to before side-effects are extremely rare and usually very minor.

We strongly recommend your baby has PNP with Zidovudine because it reduces the risk of infection in your baby. The following is a list of very uncommon side-effects which you should be aware of, but if something feels out of the ordinary with your baby then contact your doctor.

• If your baby develops rashes, please speak to your doctor/ nurse as soon as possible.
• If their skin or eyes look yellow (jaundice), please speak to your doctor/nurse as soon as possible.
• If your baby looks like they are in pain (prolonged crying, drawing of knees into the tummy, arching of their back, is very sleepy, appears less hungry) call your doctor.
• If your baby appears generally unwell or has problems with breathing take them to your doctor or hospital straight away.
• Very rarely, Zidovudine can cause seizures (fits). If your baby has a seizure, call 999.

How to give zidovudine

The dose will depend on the weight of your baby and will be printed on the label on the bottle. Zidovudine is usually given twice a day, once in the morning and once in the evening.

Ideally, these times are 12 hours apart, for example 7am and 7pm. You can give Zidovudine before, with or after a feed. Try to spread the doses apart as evenly as you can.

If your baby starts taking the medicine in the middle of the night whilst you are in hospital then, before you go home, talk to your doctor or midwife about how to change the timing of the medicine.

Zidovudine liquid is supplied with an oral dosing syringe and a plastic adaptor. Please ensure you know how to use these to give your baby their medicine and ask if unsure. Do not mix the medicine(s) directly with fee.

What shall I do if my baby is sick (vomits) after giving their Zidovudine dose?

• If your baby is sick less than 30 minutes after having a dose of Zidovudine, give them the dose again.
• If your baby is sick more than 30 minutes after having a dose of Zidovudine you do not need to give them another dose.
• If your baby is sick repeatedly (it is normal for healthy babies to vomit small amounts), seek advice from your midwife or nurse or doctor.

What do I do if I forget to give my baby their Zidovudine dose?

Please do not worry as this may occasionally happen.

If you miss a dose follow the advice below:

• Give the missed dose as soon as you remember.
• If you remember within two hours of the next dose, just skip the dose and give the next dose straightaway. Then continue your baby’s treatment as before.
• If you are having problems remembering to give your baby their medicine, speak to your doctor/midwife now and they may be able to help you.

Can other medicines be given at the same time as Zidovudine?

Check with your doctor or pharmacist before giving any other medicines to your baby. This includes prescription medicines, herbal or complementary supplements and vitamins.

Feeding your baby

If your baby is at risk of infection, the safest way to feed your baby (in the UK) is to bottle-feed using formula milk, as this carries zero risk for your baby.

If you wish to breastfeed, please discuss with your doctor or midwife. The risk of passing on infection through breast-milk is estimated at about 3/1000.

If you have any questions about this leaflet or the medicines described, please use the contacts below during office hours. Outside these times speak to your GP, you can call 111 if it is urgent or in an emergency go to A&E.

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