FAQ: Can a mother with HIV breastfeed?
The Mother to Child Transmission of HIV
The transmission of HIV from the mother to the child can occur during pregnancy, childbirth and breastfeeding. The risk of transmission during pregnancy is about 7%. The risk during childbirth is up to 15%. And the risk during breastfeeding is also up to 15%.
WHO has assisted each country to form guidelines to decide whether they will recommend breastfeeding while receiving appropriate medical interventions or they will avoid breastfeeding and recommend alternative feeding methods. Many developed countries recommend avoiding breastfeeding completely. India has adopted the policy for all mothers to breastfeed irrespective of their HIV status. Based on the new evidence, the WHO, for the first time, now recommends that HIV-positive mothers or their infants take antiretroviral drugs throughout the period of breastfeeding and until the infant is 12 months old. Recent studies have found that HIV transmission reduced to just 1.8% for infants given the antiretroviral drug nevirapine daily while breastfeeding for 6 months.
Revised WHO Recommendations on the use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants (2009)
The 2009 recommendations provide two alternative options for women who are not on
ART and breastfeed in resource-limited settings:
1) If a woman received AZT during pregnancy, daily nevirapine is recommended for her child from birth until the end of the breastfeeding period.
2) If a woman received a three-drug regimen during pregnancy, a continued regimen of triple therapy is recommended through the end of the breastfeeding period.
Some specific guidelines followed in India are given in the table below.
The Option of Alternative or Replacement Feeding
Many developed countries including the USA have adopted the policy to avoid breastfeeding completely when the mother is HIV positive. In these countries, the state supports infant feeding. There is access to alternatives and clean water etc. In India, if HIV positive Mothers from high income families choose not to breastfeed, replacement feeding can be advocated. This option is chosen on the following AFASS criteria.
A - Acceptable
F - Feasible
A - Affordable
S - Safe
S - Sustainable
When the mother chooses not to breastfeed, her options of alternative feedings are the following.
What not to do?
IYCN Course, BPNI Maharashtra
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DISCLAIMER: THE FAQ ARTICLES ARE INTENDED AS A SOURCE OF BASIC INFORMATION AND AN EXTENSION OF SUPPORT FROM BREASTFEEDING PARENTS TO BREASTFEEDING PARENTS. IT DOES NOT CLAIM TO REPLACE ANY MEDICAL ADVICE.
* MEDICAL DISCLAIMER: THE ADVICE SUGGESTED BY THE LACTATION CONSULTANTS/STANPAN SAATHIS/WEBINAR HOSTS ARE THEIR OWN. TO ACCEPT AND TO ACT ON THOSE IS AT THE SOLE DISCRETION OF THE INDIVIDUAL WHO IS SEEKING SUPPORT. IN NO WAY SHOULD THE ADVICE GIVEN REPLACE A MEDICAL DIAGNOSIS OR ADVICE FROM A QUALIFIED PROFESSIONAL. IF THAT HAPPENS, IT'S AT THE SOLE DISCRETION OF THE INDIVIDUAL WHO CHOOSES TO DO THAT. BSIM WILL NOT BE HELD RESPONSIBLE OR LIABLE FOR ANY CONSEQUENCES.
WE UNDERSTAND AND ACKNOWLEDGE THAT PARENTS AND BABIES CAN BE OF VARIOUS GENDERS ON A SPECTRUM OF THE LGBTIQA+. FAMILIES COME IN DIVERSE FLAVOURS. HOWEVER, IN OUR ARTICLES, FOR THE SAKE OF SIMPLICITY AND CONVENIENCE, WE WILL BE REFERRING TO THE BREASTFEEDING PARENT AS THE MOTHER AND USING THE FEMALE PRONOUNS- 'SHE' AND 'HER' FOR BABIES. BABIES CAN BE NOURISHED AND NURTURED IN DIFFERENT WAYS AND WHILE WE HAVE USED THE TERMS BREASTFEEDING AND NURSING, WE RECOGNIZE THAT PARENTS CAN OPT TO CHEST FEED OR FINGER FEED.
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