HIV and Breastfeeding

In resource-poor settings where there isn't guaranteed sanitation and clean water, breastfeeding is a necessity for infant survival. Unfortunately, many of these locations also have high HIV rates. Past studies have found that HIV is present in breast milk and may be transmitted through breast milk. About 15% of children contract the virus during early childhood, and breastfeeding may be the reason.

In many African nations, the choice between keeping your child alive by breastfeeding, but weighing the risk that the uninfected child may become infected with HIV through breast milk, is a real one. Ceasing breastfeeding is associated with increased infant mortality and morbidity.

The World Health Organization says that

exclusive breastfeeding for up to six months is associated with a three to fourfold decreased risk of transmission of HIV compared to non-exclusive breastfeeding; mixed feeding, therefore, appears to be a clear risk factor for postnatal transmission.

It is also important to note that in the case where a child is already infected with HIV, breastfeeding prolongs life. For a long time the WHO's recommendation for breastfeeding while HIV positive was,

HIV-infected women breastfeed their infants exclusively for the first six months of life, unless replacement feeding is acceptable, feasible, affordable, sustainable and safe for them and their infants before that time. When those conditions are met, WHO recommends avoidance of all breastfeeding by HIV-infected women.

Recently, the WHO had changed their recommendations to continue breastfeeding "until the infant is 12 months of age, provided the HIV-positive mother or baby is taking ARVs (antiretrovirals) during that period."




BUT, new research suggests the possibility that HIV may not actually be transmitted via breast milk. Partly, a very recently published research study seeks to explore why many children breastfeed from an HIV-infected mother and yet never contract the virus. The study, done with mice carrying human tissue, found that "human breast milk has potent HIV inhibitory activity that can prevent oral transmission." There is some unknown component of breast milk that kills the HIV virus, virus-infected cells, and prevents transmission.

Researchers also emphasized that HIV transmission can be further prevented from being transmitted over prolonged breastfeeding by systematically administering antiretrovirals. This may be useful if, in fact, transmission isn't occurring via breast milk but via some other oral transmission (such as blood via mother's cracked nipples).

Another interesting thing to note is that this research was done at the University of North Carolina at Chapel Hill, and extremely similar research findings was also announced by researchers at Duke University (rivalry!). The Duke study found that antibodies that help to stop the HIV virus can be found in breast milk.

I think things look very promising! What do you think?