HIV, with Dr. Watiti

Dec 27, 2010

WHILE trying to answer your question, I got advice from Dr. Ivy Kasirye, a paeditrician at Mildmay Uganda. She says although it is true that formula feeding may eliminate the risk of mother-to-child transmission (MTCT) of HIV through breastfeeding, it increases the risks of other problems like diarr

Dear Doctor,
I am six months pregnant and on ARVs (Nevirapine, Truvada and Septrin). I have been advised by my doctor to breastfeed exclusively for six months after giving birth as per the new health ministry recommendations. However, I might be able to breastfeed for only three months because that is the duration of my maternity leave. Won’t my baby get the virus through the breast milk when I stop breasfeeding exclusively? I am aged 38 and this is my first child, so you can imagine what a treasure he or she will be. Should I breastfeed for the first three months or administer formula feeding while observing strict hygiene? The major concern about formula seems to be hygiene and affordability.
Joan

Dear Joan,
WHILE trying to answer your question, I got advice from Dr. Ivy Kasirye, a paeditrician at Mildmay Uganda. She says although it is true that formula feeding may eliminate the risk of mother-to-child transmission (MTCT) of HIV through breastfeeding, it increases the risks of other problems like diarrhoea, malnutrition and development of diabetes later in life.

Research has shown that there is increased mortality in these infants compared to their breastfed counterparts — especially due to diarrhoea and malnutrition — sometimes cancelling the gains of preventing HIV transmission.

Breastfeeding while on antiretriviral treatment (ART) with a maximally suppressed viral load carries a much lower risk of HIV transmission than in an individual who is not on ART.

The new guidelines recommend exclusive breastfeeding for the first six months and thereafter, adding complementary feeds and continuing breastfeeding up to one year in a bid to improve child survival.

These guidelines also recommend ART for the mother and/or the baby throughout the breastfeeding period to reduce the risk of MTCT. However, if an affordable, feasible, acceptable, sustainable and safe alternative to breast milk can be provided; then this may be an option.

A thorough objective evaluation for formula milk using the above criteria needs to be carried out. You, therefore, need to discuss with a paediatrician or nutritionist who will assess you and guide you on how much formula is required, considering the child is growing and to evaluate if actually this is a safe option for you.

If formula milk is the option, you can use it. However, if you do not meet the criteria, you should breastfeed exclusively for six months.

Since you are a working mother, you can express your breast milk and have it stored for use while you are away at work.

(adsbygoogle = window.adsbygoogle || []).push({});