World Breastfeeding Week: Infant feeding and HIV




Four ways you can help women with HIV during World Breastfeeding Week

A message from the Infant & Young Child Nutrition Project and the Elizabeth Glaser Pediatric AIDS Foundation

August 5, 2009

Dear colleagues,

Did you know that infants who are not breastfed are at a greater risk for malnutrition, diarrheal disease, respiratory infections, and death, regardless of their HIV status?

And did you know that experts estimate that up to a third of all pediatric HIV infections can be attributed to breastfeeding?

So for HIV-positive mothers, the decision to breastfeed or not to breastfeed is a balance of risks: while breast milk provides the nutrition and immunological protection that infants need to thrive, it also carries an ongoing risk for HIV transmission. This may seem like a no-win situation, but it doesn’t have to be.

Research and practice have shown that there are ways to significantly reduce the chances that an HIV-positive mother will transmit the virus to her infant through breastfeeding. These strategies can help ensure that HIV-exposed infants receive the critical benefits that breast milk provides, while still being protected from contracting HIV.

Here are four key strategies that make breastfeeding dramatically safer in the presence of HIV:

1. Promote exclusive breastfeeding (i.e., giving only breast milk) from birth to 6 months. Exclusive breastfeeding has been shown to significantly reduce the risk of HIV transmission compared to non-exclusive breastfeeding (i.e., giving breast milk plus other liquids or foods).  

2. Promote proper breastfeeding techniques. Breast-health problems such as mastitis and cracked nipples can increase the risk of HIV transmission through breast milk. Proper breastfeeding techniques help to prevent these breast problems and reduce the risk of transmission. Quickly treating any problems that do arise also reduces this risk.

3. Closely monitor the infant’s health. Oral thrush and other health problems can increase the infant’s risk of contracting HIV through breastfeeding, so health care providers and mothers should look for and treat any health problems as soon as they occur.

4. Use appropriate antiretroviral (ARV) drug regimens. Immunocompromised mothers are more likely to transmit HIV to their infants during pregnancy, delivery, and breastfeeding. It is critical to provide ARV treatment to mothers who need it for their own health, and to use appropriate prophylactic ARV regimens. Furthermore, recent studies have demonstrated that certain ARV regimens given to HIV-positive breastfeeding mothers, their infants, or both during the breastfeeding period can further reduce the risk of HIV transmission through breast milk.

Although replacement feeding with a breast milk substitute, such as commercial infant formula, prevents infants from being exposed to HIV in breast milk, it is associated with a dramatically higher risk of infant illness and death in resource-limited settings. Furthermore, women who do not breastfeed are often stigmatized, and in many parts of the world, replacement feeding is not culturally acceptable. For these reasons, the World Health Organization recommends that HIV-exposed infants be exclusively breastfed for the first six months of life, unless replacement feeding is acceptable, feasible, affordable, sustainable, and safe.

Finally, even with the best ARV regimens and optimal feeding practices, some infants may still become HIV infected. Breastfeeding is even more critical to the health of infants with HIV, who desperately need the immunological protection and nutrition that breast milk provides.

August 1 through 7 is World Breastfeeding Week—a time to reinforce the importance of breastfeeding for infant health and survival, as well as the importance of making breastfeeding safer in the presence of HIV. Here are four ways you can learn more about infant feeding and HIV during World Breastfeeding Week:

1. View IYCN’s library of infant feeding and HIV training materials, publications, and other resources

2. Sign up for the IYCN Update to receive updates on new research and resources related to infant feeding and HIV.

3. Take Action: Sign up to receive the latest news and information from the Elizabeth Glaser Pediatric AIDS Foundation, including how you can make your voice heard in Congress and help women and children with HIV.

4. Learn more about breastfeeding and HIV from the Infant & Young Child Nutrition Project or the Elizabeth Glaser Pediatric AIDS Foundation.

During World Breastfeeding Week, let’s commit to helping women living with HIV and their babies to halt the spread of the virus.

Thanks for your support!