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  • Title: Should the threat of HIV affect breastfeeding?
    Author: Finger WR.
    Journal: Netw Res Triangle Park N C; 1992 Oct; 13(2):12-4. PubMed ID: 12286077.
    Abstract:
    About 33% of infants born to HIV positive women acquire HIV. Since breast milk has disease-protecting antibodies and diluting infant formula with unsafe water poses sizable health hazards, it is difficult for countries to set sound policy on breast feeding and for health workers to counsel HIV infected mothers and those at high risk of HIV infection. In 1985, US and UK public health officials advised HIV infected mothers to bottle feed. They eventually amended their position by claiming the guidelines only applied to the US and the UK where safe water is exists. WHO recommends that the only HIV infected women who should use a breast milk substitute are those in countries where infectious diseases are not the leading causes of infant death or those in countries with widespread malnutrition and infectious diseases which do cause infant death, but whose conditions would allow an appropriate alternative. In Rwanda, a study on HIV transmission via breast milk shows infants seroconvert during the same month as do the mothers. So the researchers advise mothers at high risk for seroconversion to not breast feed; yet all women in Rwanda are at high risk. In Haiti, where all women are also at such risk and have no breast milk substitutes, the HIV transmission rate among breast fed infants is 25%, equalling that of non breast fed infants in the US and Europe. A European and Australian study also reveals a higher risk of HIV transmission via breast milk in mothers who acquired HIV postpartum than in those who acquired it prenatally. Some research shows that 24% of the colostrum of HIV infected mothers has P24 antigen, while there is no P24 antigen in 4-day postpartum breast milk. Policymakers should develop an algorithm for health providers to use to advise mothers about the relative benefits and risks of breast feeding concerning HIV transmission.
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