Fact Sheet Expert Opinion Photo Essay


Infant feeding and HIV

Risks and benefits of breastfeeding

For HIV-positive mothers, the decision about whether or not to breastfeed a child can be a frightening dilemma. The dangers of breastfeeding must be compared with the risks of not breastfeeding. Babies who breastfeed from HIV-positive mothers have a 10 to 20 percent chance of becoming infected

However, babies who do not breastfeed are six times more likely to die from diarrhoea or respiratory infections than babies who do breastfeed. Moreover, breastfeeding provides complete nutrition and strengthens a baby's immune system. So, how should a woman make the choice as to whether or not she should breastfeed?

The first step is to get tested. If a woman determines that she is HIV negative, there is no question. She should breastfeed. If she is HIV positive, she should consider replacement feeding. Baby formula is an option only if a mother has access to clean drinking water and can afford enough baby formula for at least six months. Other possibilities include home-prepared modified animal milk, heat-treated expressed breastmilk, milk from breastmilk banks or wet nursing.

If replacement feeding is not a safe or sustainable option, then it is recommended that she shorten the duration that she breastfeeds her child to six months. The longer a child is breastfed by an HIV-infected mother, the higher the child's risk of contracting the disease. Infants who breastfeed for six months have about one third the risk of HIV infection of children who breastfeed for two years.

During the initial six months, it is also recommended that mothers rely exclusively on breastfeeding for at least the first three months. This is recommended because a study conducted in South Africa showed that babies who were exclusively breastfed had a lower chance of contracting the disease than those who received food, juice or water from other sources along with breast milk.
HIV-positive mothers who opt to breastfeed can take several other precautions to lessen the chances of passing the infection to their infants. These include: preventing or treating breast problems such as cracked nipples, mastitis and other forms of breast inflammation, as well as immediately treating any sores or thrush that develop in the infant's mouth.