HIV/AIDS- Flash heating breast milk reduces transmission risk
Jun 07, 2009
DELIVERING and raising an HIV-negative baby seems a nightmare to many positive mothers in Uganda. Many resort to moving from one place to another in search of solutions.
By Gloria Kirungi
DELIVERING and raising an HIV-negative baby seems a nightmare to many positive mothers in Uganda. Many resort to moving from one place to another in search of solutions.
Statistics show that about 1.3 million children are living with HIV worldwide. About 3.8 million deaths have occurred since the beginning of the AIDS epidemic, which is justification for the uncertainty among HIV-positive mothers.
Mother-To-Child-Transmission (MTCT) of HIV, the predominant mode of HIV acquisition among children, occurs mainly through breast-feeding.
However, the risk of HIV transmission through breast-feeding is estimated to be between seven and 22% because replacement feeding which guarantees 100% HIV safety of the infant is not acceptable, feasible, affordable, sustainable and safe (AFASS) in most cases.
In Uganda, exclusive breast-feeding, replacement feeding and ARV prophylaxis to breast-feeding babies, are some feasible approaches geared towards the reduction of post-natal MTCT of HIV.
Against this background, the World Health Organisation (WHO) recommends exclusive breastfeeding of infants for HIV–infected mothers for the first six months unless replacement feeding is safe for them and their infants before that time.
Prevention of mother-to-child transmission through breastfeeding is therefore possible with the following:
No breastfeeding from birth if replacement feeding is safe
Breastfeeding exclusively for three to six months.
If replacement feeding is still not safe at six months, breastfeeding should continue with complementary feeding until a nutritionally adequate and safe diet can be provided.
The benefits of breastfeeding are not disputable, but the reality of prolonged breastfeeding and erosion of the efficacy of antiretroviral prophylaxis make it impossible for mothers to practice exclusive breastfeeding for the first six months.
Breastfeeding is associated with a 10 – 15% increased risk of HIV transmission. Some HIV-positive mothers stop breastfeeding, especially in a bid to reduce the risk of transmitting the virus to their children.
Replacement feeding (after six months) where social, economic and environmental circumstances allow, would be the ideal alternative to prevention of MTCT, but this increases the risk of infant mortality.
However, HIV-positive mothers should not worry about this any more.
They may now be able to breastfeed their babies even after six months with limited risk of HIV transmission using the flash heating method.
According to Dr. Margaret Ash, local pasteurisation of breast milk inactivates the HIV virus, kills bacteria and preserves:
Immunoglobulin
Vitamins
Anti-bacterial activity for 6-8 hours
Lactoferrin concentration and 90% bioactivity
Lysozyme
What is flash heating of breast milk?
It is a simple in-home pasteurisation method of heating breast milk to destroy the HIV, while retaining the important foods and protective agents. This allows an HIV-positive mother to continue providing breast milk to her baby.
Advantages
Flash heating is a potential method of improving infant health outcomes of HIV-exposed infants because it is acceptable, feasible, affordable, safe and sustainable.
It can be used for protection in periods of high risks. These include:
During and after introduction of complementary foods
Risk from lack of breast milk immune protection
Risk from lack of adequate nutrition
Risk from increase in breast milk viral load
Mastitis
Thrush
Cracked nipples
At low risk times
How to safely heat treat breast milk
Wash all utensils that you will use to express and heat the milk with clean water and soap
Express your milk, empty both breasts
Put all the milk you have expressed in a jar, glass or bottle that will not break when you heat it (do not use plastic container). The milk should be between 50ml and 150ml, if you have more milk, you may have to divide it into 2 jars.
Place the jar of milk in a small pan of water and ensure the water is two figures above the level of the milk so that all the milk will be heated well.
Be careful not to boil the milk, only the water has to boil
Heat the water with very hot fire until it reaches a rolling boil. Stay close because this takes a few minutes. Leaving the water to boil too long damages some nutrients in the milk.
Remove the jar of milk from the boiling water immediately the water boils. Cool it to room temperature.
Placing a clean lid or small plate on the jar to protect the milk as it cools
You can safely feed your baby with the milk within six hours
Always feed the baby using a clean cup.
Even a new born learns how to drink from a cup quickly. Do not use bottles, teats or sprouted cups. They are difficult to clean and may make your baby sick.
You should get more information from your nutritionist / pediatrician on this method before using it.
The writer is a nutritionist / dietitian
kirungigloria@yahoo.com
DELIVERING and raising an HIV-negative baby seems a nightmare to many positive mothers in Uganda. Many resort to moving from one place to another in search of solutions.
Statistics show that about 1.3 million children are living with HIV worldwide. About 3.8 million deaths have occurred since the beginning of the AIDS epidemic, which is justification for the uncertainty among HIV-positive mothers.
Mother-To-Child-Transmission (MTCT) of HIV, the predominant mode of HIV acquisition among children, occurs mainly through breast-feeding.
However, the risk of HIV transmission through breast-feeding is estimated to be between seven and 22% because replacement feeding which guarantees 100% HIV safety of the infant is not acceptable, feasible, affordable, sustainable and safe (AFASS) in most cases.
In Uganda, exclusive breast-feeding, replacement feeding and ARV prophylaxis to breast-feeding babies, are some feasible approaches geared towards the reduction of post-natal MTCT of HIV.
Against this background, the World Health Organisation (WHO) recommends exclusive breastfeeding of infants for HIV–infected mothers for the first six months unless replacement feeding is safe for them and their infants before that time.
Prevention of mother-to-child transmission through breastfeeding is therefore possible with the following:
No breastfeeding from birth if replacement feeding is safe
Breastfeeding exclusively for three to six months.
If replacement feeding is still not safe at six months, breastfeeding should continue with complementary feeding until a nutritionally adequate and safe diet can be provided.
The benefits of breastfeeding are not disputable, but the reality of prolonged breastfeeding and erosion of the efficacy of antiretroviral prophylaxis make it impossible for mothers to practice exclusive breastfeeding for the first six months.
Breastfeeding is associated with a 10 – 15% increased risk of HIV transmission. Some HIV-positive mothers stop breastfeeding, especially in a bid to reduce the risk of transmitting the virus to their children.
Replacement feeding (after six months) where social, economic and environmental circumstances allow, would be the ideal alternative to prevention of MTCT, but this increases the risk of infant mortality.
However, HIV-positive mothers should not worry about this any more.
They may now be able to breastfeed their babies even after six months with limited risk of HIV transmission using the flash heating method.
According to Dr. Margaret Ash, local pasteurisation of breast milk inactivates the HIV virus, kills bacteria and preserves:
Immunoglobulin
Vitamins
Anti-bacterial activity for 6-8 hours
Lactoferrin concentration and 90% bioactivity
Lysozyme
What is flash heating of breast milk?
It is a simple in-home pasteurisation method of heating breast milk to destroy the HIV, while retaining the important foods and protective agents. This allows an HIV-positive mother to continue providing breast milk to her baby.
Advantages
Flash heating is a potential method of improving infant health outcomes of HIV-exposed infants because it is acceptable, feasible, affordable, safe and sustainable.
It can be used for protection in periods of high risks. These include:
During and after introduction of complementary foods
Risk from lack of breast milk immune protection
Risk from lack of adequate nutrition
Risk from increase in breast milk viral load
Mastitis
Thrush
Cracked nipples
At low risk times
How to safely heat treat breast milk
Wash all utensils that you will use to express and heat the milk with clean water and soap
Express your milk, empty both breasts
Put all the milk you have expressed in a jar, glass or bottle that will not break when you heat it (do not use plastic container). The milk should be between 50ml and 150ml, if you have more milk, you may have to divide it into 2 jars.
Place the jar of milk in a small pan of water and ensure the water is two figures above the level of the milk so that all the milk will be heated well.
Be careful not to boil the milk, only the water has to boil
Heat the water with very hot fire until it reaches a rolling boil. Stay close because this takes a few minutes. Leaving the water to boil too long damages some nutrients in the milk.
Remove the jar of milk from the boiling water immediately the water boils. Cool it to room temperature.
Placing a clean lid or small plate on the jar to protect the milk as it cools
You can safely feed your baby with the milk within six hours
Always feed the baby using a clean cup.
Even a new born learns how to drink from a cup quickly. Do not use bottles, teats or sprouted cups. They are difficult to clean and may make your baby sick.
You should get more information from your nutritionist / pediatrician on this method before using it.
The writer is a nutritionist / dietitian
kirungigloria@yahoo.com