From the Guidelines
HIV-positive mothers can breastfeed while taking antiretroviral therapy (ART), as the risk of HIV transmission through breast milk can be significantly reduced to less than 5% with effective ART, as stated in the study by 1. The World Health Organization recommends that mothers living with HIV should breastfeed for at least 12 months and may continue breastfeeding for up to 24 months or longer, similar to the general population, while being fully supported for ART adherence 1. The key factors to consider are:
- The mother's access to consistent and effective ART
- The availability of clean water and formula in the setting
- The risks of not breastfeeding, such as malnutrition and diarrheal disease
- The mother's adherence to her prescribed ART medication throughout the breastfeeding period
- The provision of prophylactic antiretroviral drugs to the infant, if necessary In resource-limited settings, the benefits of breastfeeding, including the nutritional and immunological benefits of breast milk, outweigh the risks of HIV transmission, as long as the mother is on effective ART 1. It is essential to note that the risk of HIV transmission through breastfeeding can be significantly reduced with the use of antiretroviral medicines, and the WHO recommends that mothers known to be HIV infected should be provided with lifelong ART or antiretroviral prophylaxis to reduce HIV transmission through breastfeeding 1. The most recent and highest quality study, 1, provides the strongest evidence for the recommendation that HIV-positive mothers can breastfeed while taking ART, and this approach should be considered in the context of the individual mother's circumstances and access to resources.
From the Research
HIV Positive Mothers and Breastfeeding
- The question of whether HIV positive mothers can breastfeed is complex and depends on various factors, including the mother's viral load and the availability of antiretroviral therapy (ART) 2.
- Research has shown that exclusive breastfeeding is safer than mixed feeding, and should be encouraged even in settings where ART for either the mother or infant is not readily available 2.
- The use of ART during pregnancy and breastfeeding has been shown to drastically reduce the risk of HIV transmission from mother to child 2.
- Infant prophylaxis has also been shown to be effective in reducing the transmission rate of HIV, with some studies reporting a transmission rate as low as 1.2% after 6 weeks 2.
Antiretroviral Therapy and Breastfeeding
- The use of antiretroviral therapy (ART) during breastfeeding has been shown to be effective in reducing the risk of HIV transmission from mother to child 2, 3, 4, 5, 6.
- Different combinations of ART have been studied, including tenofovir disoproxil fumarate, emtricitabine, and efavirenz, as well as rilpivirine, emtricitabine, and tenofovir 3, 4, 5.
- These studies have reported varying degrees of success in reducing HIV transmission and improving the health outcomes of HIV positive mothers and their infants.
Safety and Efficacy of Breastfeeding for HIV Positive Mothers
- The safety and efficacy of breastfeeding for HIV positive mothers depends on various factors, including the mother's viral load, the availability of ART, and the infant's health status 2.
- Research has shown that breastfeeding can be a safe and effective way for HIV positive mothers to feed their infants, as long as the mother is receiving effective ART and the infant is receiving prophylaxis 2.
- However, more research is needed to fully understand the risks and benefits of breastfeeding for HIV positive mothers and their infants.