Mothers living with HIV/AIDS: Breastfeeding is still the best
Sep 26, 2010
INFANT feeding in the era of HIV/AIDS is a serious challenge to mothers living with HIV/AIDS, especially those in low-income countries.
By Rebecca Kivumbi
INFANT feeding in the era of HIV/AIDS is a serious challenge to mothers living with HIV/AIDS, especially those in low-income countries.
While breastfeeding increases the risk of HIV transmission from the mother to the child, giving replacement feeds or breast milk substitutes is worse because it increases the risk of severe malnutrition, diarrhoea and respiratory tract infections.
During my medical practice, I have come across mothers trying to feed their children of less than one year of age on breast milk substitutes (formula or cow’s milk). All the mothers are trying to do is to prevent their children from acquiring HIV through breast milk. Many times, these mothers also face cultural and social challenges as it is not easy to explain to in-laws why they are not breastfeeding.
It is Uganda’s national policy to test all pregnant mothers for HIV/AIDS. Mothers who are found positive are counselled on the different options of feeding their babies and left to make a choice on what method to use.
Among the alternatives is breastfeeding exclusively for six months without giving other feeds. After six months, the mother introduces other feeds and stops breastfeeding. The point here is not to mix breastfeeding with other foods.
Another alternative is not to breastfeed at all. Instead, give formula or cow’s milk. Breastfeeding contributes to between 15% and 20% of mother-to-child HIV transmissions.
Many mothers often choose replacement feeding.
However, breast milk substitutes are not affordable, not readily available, not sustainable and might not even be safe. More so, the child is in more danger of dying from malnutrition, diarrhoea and other infections because formula feeds have no protective agents to guard the baby against infections.
Studies have shown that where there is little access to clean water, sanitation, health services and limited access to formula or cow’s milk, children on replacement feeds have a high risk of contracting diseases or even dying.
But the latest guidelines from the World Health Organisation are that in order to reduce the risk of the baby becoming infected through breast milk, babies should be breastfed exclusively for six months; thereafter, other foods are introduced, while breastfeeding continues up to one year. During this time, either the mother or the baby should be on ARVs.
To further reduce the risk of HIV transmission, mothers should prevent breast sores and cracks by correctly positioning and attaching the baby to the breast.
If an infant is known to be HIV-positive, mothers are encouraged to exclusively breastfeed for six months and continue breastfeeding up to two years.
Enhanced with good nutrition for the mother, breastfeeding is still golden and can improve child health. Remember to see your health worker for detailed advice.
The writer is a paediatrician
INFANT feeding in the era of HIV/AIDS is a serious challenge to mothers living with HIV/AIDS, especially those in low-income countries.
While breastfeeding increases the risk of HIV transmission from the mother to the child, giving replacement feeds or breast milk substitutes is worse because it increases the risk of severe malnutrition, diarrhoea and respiratory tract infections.
During my medical practice, I have come across mothers trying to feed their children of less than one year of age on breast milk substitutes (formula or cow’s milk). All the mothers are trying to do is to prevent their children from acquiring HIV through breast milk. Many times, these mothers also face cultural and social challenges as it is not easy to explain to in-laws why they are not breastfeeding.
It is Uganda’s national policy to test all pregnant mothers for HIV/AIDS. Mothers who are found positive are counselled on the different options of feeding their babies and left to make a choice on what method to use.
Among the alternatives is breastfeeding exclusively for six months without giving other feeds. After six months, the mother introduces other feeds and stops breastfeeding. The point here is not to mix breastfeeding with other foods.
Another alternative is not to breastfeed at all. Instead, give formula or cow’s milk. Breastfeeding contributes to between 15% and 20% of mother-to-child HIV transmissions.
Many mothers often choose replacement feeding.
However, breast milk substitutes are not affordable, not readily available, not sustainable and might not even be safe. More so, the child is in more danger of dying from malnutrition, diarrhoea and other infections because formula feeds have no protective agents to guard the baby against infections.
Studies have shown that where there is little access to clean water, sanitation, health services and limited access to formula or cow’s milk, children on replacement feeds have a high risk of contracting diseases or even dying.
But the latest guidelines from the World Health Organisation are that in order to reduce the risk of the baby becoming infected through breast milk, babies should be breastfed exclusively for six months; thereafter, other foods are introduced, while breastfeeding continues up to one year. During this time, either the mother or the baby should be on ARVs.
To further reduce the risk of HIV transmission, mothers should prevent breast sores and cracks by correctly positioning and attaching the baby to the breast.
If an infant is known to be HIV-positive, mothers are encouraged to exclusively breastfeed for six months and continue breastfeeding up to two years.
Enhanced with good nutrition for the mother, breastfeeding is still golden and can improve child health. Remember to see your health worker for detailed advice.
The writer is a paediatrician