LLLI Center for Breastfeeding Information
Journal Abstract of the Month for March 2005
"Current Status of HIV and Breastfeeding Research"
Author: Anna Coutsoudis, PhD
Breastfeeding Abstracts. 2005 February; 24:11-12.
Some studies reporting the risk of transmission of HIV through breastfeeding did not investigate the risk of breastfeeding transmission during exclusive breastfeeding (EBF). Exclusive breastfeeding is defined as feeding an infant only breast milk; in contrast to mixed breastfeeding, defined as the feeding of breast milk along with complementary foods, other milks, and/or infant formula.
The first study to examine the influence of EBF found that the cumulative probability of HIV infection was similar among never breastfed and EBF infants up to 6 months, but was significantly higher for infants who received mixed breastfeeding. At the International AIDS Conference in Bangkok in July, 2004, studies presented confirmed that EBF carries a much lower risk of HIV transmission than mixed feeding.
In a meta-analysis of 9 large studies it was clearly shown that breastfeeding does not pose any mortality or other health risk to the HIV-infected mother.
In developed countries reduction of mortality from infections is unlikely as children have access to health care. But even in developed countries breastfeeding may protect against bacterial and viral infections; and later onset of health problems such as diabetes, cardiovascular disease, and cancer.
In additional to the information about EBF, an option given is that mother could express and pasteurize her milk, as this has been shown to effectively kill all cell-free HIV. Also, giving highly active anti-retroviral therapy (HAART) to the infant and/or mother during the lactation period could reduce transmission. Given that the viral load in women on HAART will be very low (at undetectable levels), there should be no, or minimal risk of breastfeeding transmission. The many recommendations given in this article should help minimize mother-to-child transmission of HIV and maximize child survival.
The entirety of this article can be read in our BREASTFEEDING ABSTRACTS collection.
The Breastfeeding and HIV International Transmission Study Group.
Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis. JID 2004; 189:2154-66.
Another Look is a nonprofit organization dedicated to gathering information, raising critical questions, and stimulating needed research about breastfeeding in the context of HIV/AIDS.
BREASTFEEDING ABSTRACTS, a quarterly publication for health professionals from La Leche League, contains feature articles, and abstracts of current breastfeeding research. To order a subscription, contact our order department on our Contact Us page.