HIV positive mothers can breastfeed exclusively without transmitting infection

Dr Abimbola Williams, the Head of Health, Save the Children Nigeria, a Non-Governmental Organisation (NGO), said mothers living with HIV could breastfeed exclusively without transmitting the virus to the baby.

She made the disclosure in an interview with the News Agency of Nigeria (NAN) on Monday in Abuja.

She said that exclusive breastfeeding helps to strengthen the immune system of a child even when the mother was HIV positive.

According to her, exclusive breastfeeding in the first six months of a child’s life is associated with a three to fourfold decreased risk of HIV transmission compared to those fed with other foods.

“What mothers don’t know is that when administering exclusive breastfeeding, the likelihood of the baby getting infected is very low.

“ The baby is predisposed to HIV infection most times due to the status of the lumen of the intestine.

“And if the baby continues to have diarrhoea while the mother breastfeeds, the chances of the child getting infected becomes high.’’

She then explained a new policy whereby HIV positive breastfeeding mothers could be placed on Antiretroviral drugs (ARV) together with the baby for a longer period in order to prevent transmission of the virus.

She said “the Antiretroviral drugs are given to prevent the small percentage of the virus from being transmitted from mother to the baby.”

She added that the policy followed a study which found that giving HIV positive mothers a combination of antiretroviral drugs during pregnancy, delivery and breastfeeding would reduce the risk of HIV transmission to infants.

Breastfeeding may be natural, but it is not always simple.

Prof. Anna Coutsoudis of the Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa, said “the problem begins in the first weeks of breastfeeding as health-care providers lack the skills needed to offer support and advice.

“So, when problems arise such as cracked nipples, babies won’t suck and don’t seem satisfied and the mothers get bad advice, then when they become discouraged, they are told to stop breastfeeding altogether and to give artificial substitutes.”

Thelma Raqa, an antenatal counsellor based in Mowbray Maternity Hospital in Cape Town, South Africa, said “if the mother is HIV positive, more uncertainty is added and some counsellors are themselves confused about what is correct practice regarding HIV and feeding practices.’’

Following the uncertainties, therefore, the World Health Organisation (WHO) advised HIV-positive mothers to avoid breastfeeding if they were able to afford, prepare and store formula milk safely.

But research has since emerged, particularly from South Africa, that shows that a combination of exclusive breastfeeding and the use of antiretroviral treatment can significantly reduce the risk of transmitting HIV to babies through breastfeeding.

On Nov. 30, 2009, WHO then released new recommendations on infant feeding by HIV-positive mothers based on this new evidence and for the first time, the world health body recommended that HIV-positive mothers or their infants should 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 very little risk of becoming infected with HIV.