Can an HIV positive mother breastfeed her baby?

WHO has come with new infant breastfeeding guidelines for HIV positive mothers and here is what you should know about it.

By: Debjani Arora | | Published: December 5, 2017 3:43 pm

Till about a decade back it was believed that mother-to-child transmission of HIV can happen in three ways during pregnancy, labour and delivery or while breastfeeding. This is why HIV positive mothers who conceive and deliver babies when they are on antiretroviral therapy and other assisted procedures are asked not to breastfeed. Here is how to conceive a baby if both partners are HIV positive.

However, on 30 November 2009, World Health Organisation or WHO released new recommendations on infant feeding by HIV-positive mothers, based on new studies. For the first time, WHO recommended that HIV-positive mothers or their infants take antiretroviral drugs throughout the period of breastfeeding and until the infant is 12 months old. This means that the child can benefit from breastfeeding with a very little risk of becoming infected with HIV. However, there are studies which concluded that benefits of breast milk can override the risk of transmission of HIV virus, especially if the mother and baby are given ART in tandem.

One study published in the journal Paediatric Drugs in the year 2010 pointed out that formula feeding, comes with its own set of risks, including a higher rate of infant mortality from diarrheal illnesses while reducing transmission of HIV. Treatment of mothers and/or their infants with antiretroviral drugs is a strategy that has been in place for several decades to reduce HIV transmission through pregnancy and delivery, but its effect on breastfeeding was not explored to the fullest. Know if a pregnant woman can also get infected with HIV.

However, some published research suggests that mothers who are treated with highly active antiretroviral therapy (HAART) during pregnancy can drastically reduce the risk of transmission of HIV. In several trials, it has been shown that treatment with antiretroviral, reduce the transmission rate after six weeks to as low as 1.2 percent. In fact, it was seen that mothers who have been on ART prior to pregnancy, during pregnancy, labour and delivery and continued with the same post delivery had fewer chances of passing the virus to the baby during breastfeeding.

Probably this is a reason why WHO recommends that all mothers, regardless of their HIV status, practise exclusive breastfeeding which means no other liquids or foods are given during the first six months. After six months, the baby should start on complementary foods.

However, we checked with doctors in India to know what is the status of HIV positive mothers in the country when it comes to breastfeeding. The stigma attached to this condition is so high that not many couples come forward with the HIV status to get help in conception. For the few who do come forward to become parents in most cases, we ask the mother not to breastfeed for the first six weeks after delivery when the chances of transmission are high. After that blood tests are done to check on the viral load of the mother after which a suitable decision is taken if she can breastfeed or not, says Dr Gauri Gore, consultant gynaecologist, Zen Hospital, Mumbai.

Reference:

1: Slater M, Stringer EM, Stringer JS. Breastfeeding in HIV-positive women: What can be recommended? Paediatr Drugs. 2010;12(1):1-9. doi: 10.2165/11316130-000000000-00000. PubMed PMID: 20034337.

Published : December 5, 2017 3:43 pm

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