Breastfeeding for HIV Positive mums

How to decrease risks of HIV transmission


Feeding guidelines for HIV mums

According to WHO/UNAIDS/UNICEF 1/3 of infants born to HIV positive mothers are infected with. This occurs Through Mother-to-child transmission during pregnancy, labor and child birth, and breastfeeding. In 2001, 800,000 children under the age of 15 contracted HIV, over 90 per cent of them through mother-to-child transmission of HIV (MTCT). Between 15 and 25% of children born to HIV-infected mothers get infected with HIV during pregnancy or delivery, while about 15% of the children get infected through breastfeeding.

Factors decreasing the risk of HIV transmission through breastfeeding include:

Shorter Breastfeeding duration.

The longer a child is breastfed by an HIV-positive mother the higher the risk of HIV infection. Breastfeeding for 6 months has about 1/3 of the risk compared to breastfeeding for 2 years.

Exclusive breastfeeding in the early months.

Some immunological studies show that there are factors in human milk, especially the milk of the HIV-infected mother that will directly combat the cells that contribute to the transmission of the HIV infection. A study done in Durban, South Africa showed that exclusive breastfeeding during the first 3 months of life resulted in a lower risk of MTCT than mixed feeding (breastfeeding combined with other foods, juices or water)

Prevention and treatment of breast problems.

Mastitis and cracked nipples and other causes of breast inflammation are associated with an increased risk of HIV-transmission.

Early and prompt treatment of infant oral thrush and sores.

Sores in the infant's mouth make it easier for the virus to enter the infant's body

Prevention of HIV-infection during breastfeeding.

The maternal viral load is higher shortly after a new infection resulting in an increased risk of infection of the child.
The risk of HIV-infection to the infant is lower compared with the risk of morbidity and mortality due to not breastfeeding. This is because breastfeeding protects against death from diarrhea, respiratory and other infections, particularly in the first months of life. Breastfeeding also provides the necessary nutritional and related ingredients, as well as the stimulation necessary for good psychosocial and neurological development, and delays new pregnancy.

Breastfeeding saves lives

For HIV-infected mothers, especially in developing countries, the decision to breastfeed or to give breast milk substitutes like infant formula or modified cow's milk provides a dilemma. While breastfeeding increases the risk of HIV-transmission to the child with up to 15%, giving breastmilk substitutes instead of breastmilk increases the risk due to infectious diseases like diarrhoea and respiratory infections about 6 times during the first 2 months.

Many mothers in developing countries cannot afford breastmilk substitutes and lack access to clean water, which is essential for their safe preparation and use. Also in many cultures there is a stigma against not breastfeeding. A mother living with HIV/AIDS therefore faces many grave difficulties: worries about her own health and survival, the risk of infecting her baby through breastmilk, and the danger that her baby will develop other health problems if she does not breastfeed

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