This qualitative study explores concerns of mothers living with HIV about the consequences of HIV exposure for their children during pregnancy and early childhood, before and beyond a final HIV negative diagnosis. Conducted in South Africa's Western Cape between January and April 2024, the study involved semi-structured interviews with 20 mothers whose children HIV-exposed, over one year old, tested HIV-negative at 12 months. The study revealed that maternal fear of vertical HIV transmission persisted throughout pregnancy and early childhood. It was triggered by breastfeeding decisions, repeated HIV testing, sickness or growth faltering in the child, and doubts about antiretroviral effectiveness. Mothers adopted coping strategies such as strict medication adherence, routine clinic visits, and heightened hygiene practices. The study indicates that comprehensive, ongoing support for mothers living with HIV throughout the early years of motherhood, including breastfeeding guidance, clear information on HIV testing protocols, and guidance on long-term implications of HIV exposure can alleviate maternal stress.