Skip to main content

The Dilemma of Postnatal Mother-to-Child Transmission of HIV: To Breastfeed or Not?

Buy Article:

$51.00 plus tax (Refund Policy)

Abstract:

The promotion of nearly universal breastfeeding has played an important role in improving child health by providing optimum nutrition and protection against common childhood infections, and by promoting child spacing. Unfortunately, it has become clear that breastfeeding is responsible also for much of the increasing burden of worldwide pediatric human immunodeficiency virus (HIV) infection, especially in the developing nations (12–14% additional risk of HIV infection transmitted by breastfeeding; 35% total proportion of all HIV-infected children in an area infected through breastfeeding). Several factors influence the transmission of HIV by breastfeeding, including whether a woman acquires her infection during breastfeeding (29% risk of transmission) or before pregnancy (7–10% risk of breastfeeding transmission),the degree of maternal plasma and breastmilk viral load, and the presence of mastitis. In areas of the world where adequate sanitary replacement feeding is not available, the decision to withhold breastfeeding so as to decrease HIV transmission may lead to increased rates of child morbidity and mortality from diarrheal and respiratory diseases, and malnutrition. This review summarizes current data on the pathophysiology of breastfeeding transmission of HIV infection, the risk factors for and incidence rates of transmission, and the feasibility of possible alternatives to exclusive breastfeeding in the setting of maternal HIV infection. Clearly, women must be fully informed about the risks of breastfeeding transmission of HIV, the risks of morbidity and mortality among nonbreastfed infants, and the expense and availability of procuring adequate replacement formula. If an uninterrupted access to a nutritionally adequate breastmilk substitute that can be safely prepared is ensured (as is possible in industrialized countries), HIV-infected women should be counseled not to breastfeed their infants. (BIRTH 27:3 September 2000)

Document Type: Research Article

DOI: https://doi.org/10.1046/j.1523-536x.2000.00199.x

Publication date: 2000-09-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more