We have stumbled across many forums and discussions, and it has come to our attention that the public is ill-informed on the facts with regards to breastfeeding and HIV. Since December 1st is World AIDS day, we wish to enlighten our readers on the most common questions with regards to feeding a baby in the context of HIV.
What is the best way to feed a baby?
Whether HIV negative or positive, exclusive breastfeeding for the first 6 months of a baby’s life is recommended. This involves giving a baby only breast milk and no other fluids or foods other than multivitamins or medications prescribed by health care workers.
If a mother is HIV positive, should she breastfeed?Definitely! There is a misconception among the public that HIV-positive moms should not breastfeed. HIV-positive moms are encouraged to exclusively breastfeed just as HIV-negative moms are. Exclusively breastfeed babies whose mothers are HIV-positive thrive and benefit just as well as babies with HIV-negative moms.
Can HIV be transmitted through breast milk?
Transmission of HIV in breast milk is as low as 1%. We now know that there is less of a chance of transmitting HIV through breast milk when antiretroviral treatment is used by either the mother or baby, compared to using no antiretrovirals. A study in Botswana showed higher survival rates among HIV-positive babies who were breastfed compared to those that were formula fed. The study also showed that 7.5% of 6 month olds who were breastfed died from diarrhea compared to 33% of formula fed babies who died from diarrhea and pneumonia. Also, research shows that there is less HIV transmission when exclusively breastfeeding a baby versus mixed feeding (feeding a combination of breast milk and infant formula).
Can HIV transmission through breast milk be prevented?
Yes HIV can be transmitted in breast milk, but to effectively reduce the transmission of HIV to the baby, the mother, baby, or both, should be placed on antiretroviral treatment. The chances of HIV transmission when a mother or baby is on antiretriovirals during breastfeeding significantly reduces the chances of HIV transmission.
The South African government has adopted a program called the prevention of mother-to-child transmission (PMTCT). This treatment is available to all HIV-potive mothers free of charge at all government hospitals and clinics. The PMTCT guidelines give recommendations on antiretroviral use during pregnancy and breastfeeding:
§ All babies whose mothers are HIV-positive must receive antiretrovirals daily for 6 weeks after birth.
§ If the mother is already on ARV treatment, she must continue to take the treatment as per normal throughout breastfeeding. In addition, the baby must receive nevirapine for the first 6 weeks.
§ If the mother is breastfeeding (and not on prior ARV treatment) then the baby must be given nevirapine throughout the breastfeeding period, plus for one week after stopping breastfeeding.
§ If the HIV positive mother is not breastfeeding, then the baby only receive nevirapine until 6 weeks after birth.
If the baby tests HIV-positive, should the mother continue to breastfeed?
If a baby tests positive for HIV, the mother should definitely continue to breastfeed. This will continue to protect the baby against infections and disease.
If an HIV positive mother chooses not to breastfeed, what are her other options?
Every mother has the right to chose how she feeds her baby. However there is great concern with formula feeding, and mothers should be thoroughly informed by trusted health care workers on the potential risks of doing so.
If a mother chooses to formula feed, the following criteria (called the AFASS criteria) must be met:
Affordable The mother must be able to afford formula as well as the necessary equipment, such as bottles, teats, and sterilization.
Feasible
Acceptable Formula feeding must be supported and accepted by the mother, guardian, caregiver, partner, and community
Safe Formula feeding must be prepared hygienically, and frequently enough that it is safe
Sustainable Breast milk is always available, reducing possibilities of difficulties in accessing supplies. There must be a reliable and sufficient supply of formula milk. Can the mother consistently feed the baby?
When must the HIV positive mother stop breastfeeding?
As we’ve established, whether HIV positive or not, babies should be exclusively breastfed until 6 months, after which solids are introduced. The only difference is in the length of breastfeeding: 24 months for HIV-negative moms, and 12 months for HIV-positive moms.§ If HIV negative: Breastfeed exclusively for 6 months. Introduce solids at 6 months and continue to breastfeed until 24 months.
§ If HIV positive: Breastfeed exclusively for 6 months. Introduce solids at 6 months and continue to breastfeed until 12 months. When the HIV positive mother stops breastfeeding, this should be done so gradually and over a period of one month.
As a final word, we encourage the public to speak to trusted health care providers, like doctors, pediatricians or dietitians, with regards to HIV and feeding a young child. Help us to pass on the correct, scientifically-based information so that South Africans stand together in support of our HIV-positive moms.
Go to the Word AIDS Day website for more information.
Go to the Word AIDS Day website for more information.
References
Department of Health. National Breastfeeding week (1-7 August 2011) - questions and answer guide.
Yezingane Network and UNICEF. Infant feeding in the context of South Africa- questions and answers. December 2010 (Updated July 2011).
Yezingane Network. Preventing mother-to-child-transmission of HIV (PMTCT). June 2010.
No comments:
Post a Comment