HIV and Breastfeeding-Risks and Benefits
Although, in most cases breastfeeding a new born infant is the preferred option for all mothers, certain exceptions produce concern for health care experts and mothers about breastfeeding as an optimal feeding source for the child. One of these exceptions is a disease of the human immune system called Acquired Immunodeficiency syndrome and it is caused by the virus Human Immunodeficiency Virus, also known as HIV. This is transmitted by the direct contact of a mucous membrane or blood stream with a bodily fluid containing the virus, and one of these fluids is breast milk.
Apart from breastfeeding, this virus can also be transmitted to the infant during pregnancy and delivery. In the absence of anti-retroviral drugs or any other intervention, between 15 to 30 percent of infants are infected with HIV during pregnancy or delivery; among all breastfed infants, around 10 to 20 percent will be infected because of it. So, two thirds of children of infected women will not be infected whereas, one third of infected children will have so through breastfeeding.
Even after a mother has been discovered to be HIV positive, there are certain choices that she can make, it is imperative that these choices be influenced by the accurate information of health experts, their support and counseling and the feasibility of the economic and social environment. It is recommended that if a mother knows she is infected and substitutes for breast milk can be provided for, along with clean water and proper health care facilities then, it is better to not breastfeed the child, as it would put the baby at a greater risk of virus transmission. On the other hand, in places where infectious diseases such as diarrhea and pneumonia increase infant mortality, proper hygiene and water are unavailable, breast milk substitutes are expensive or unhealthy and adequate health facilities are not available, then breast feeding is the best chance of survival for the infant.
HIV positive mothers wishing to breastfeed their infants can do so by considerably reducing the risk of virus transmission, however, this is recommended only when necessary. Unfortunately, many parts of the world make artificial feeding of an infant impossible due to economic and social factors. First of all HIV positive mothers choosing to breastfeed must do so exclusively for the first six months; adding other fluids or solids even water to the diet of the new born is not only unnecessary but also can increase the risk of transmission but contracting infections. Mixed feeding that is, breastfeeding as well as feeding other foods is highly discouraged since it can irritate the lining of the baby’s stomach, increasing risks of HIV transmission. Secondly, the HIV positive mother should try to limit the total duration of breastfeeding since the chances of transmission exist as long as breastfeeding does. So, if replacement methods of feeding become available and feasible, it is recommended that mothers discontinue to breastfeed. Thirdly, mothers should avoid problems such as oral lesions in the baby and breast problems such as sore nipple in the mother since they can increase risk of transmission. A lot of programs also advocate and strive to make common and encourage use of anti-retroviral drugs since these can be helpful in reducing possibility of transmission via breastfeeding. Alternate strategies can be adopted by HIV positive mothers; leaving expressed milk at room temperature or pasteurizing it can eliminate or reduce the chances of baby getting HIV. Milk can easily be expressed using manual or electric breast pumps like ameda breast pump. Information on pumps can be found online at www.trusted-breast-pumps.com. If lucky, mothers can also provide breast milk from alternate sources, possibly through HIV negative women, for their baby. It is important to note that in many cases, mothers are not provided with enough information and counseling to make the optimal decision; they must take special care of their own health while breastfeeding.
On a larger scale, measures have to be taken to support breastfeeding and implement ways to minimize risk of HIV transmission. Women should be helped to avoid the infection completely by promoting safer sexual behavior; reducing the number of sexual contacts, and condom usage can contribute in avoiding the infection. Health care providers and influential groups should have accurate technical information so that people are spared the consequences of misinformation. Confidential HIV testing and counseling for both men and women can help spread awareness and encourage people to communicate further the advantages of knowing one’s HIV status. For all women who are not infected, breastfeeding remains the optimal choice for feeding the baby since it fulfills the nutritional requirements and strengthens the baby’s immune system increasing its overall chances of survival.
