LUSAKA, Zambia — Receiving an HIV diagnosis is traumatic and life altering enough as is, so when it comes to keeping one’s children as safe from infection as possible, it is difficult to sort through all of the information to know whether breastfeeding with HIV is safe. Due to the nature of HIV transmission, and its high volume in impoverished areas in Africa, the confusion revolving around breastfeeding with HIV is understandable.
In general, breastfeeding is considered vital for transferring important nutrients as well as immune system supporting elements from mother to child. This means that life-threatening infections, such as pneumonia and diarrhea, are often warded off by breastfeeding. Sacrificing breastfeeding to prevent the transfer of HIV often means leaving the child vulnerable to other potentially fatal illnesses.
So how does one make the impossible choice of which illness to leave their child susceptible to? Fortunately, research has shown that this difficult choice may not be necessary. HIV can indeed be passed through breast milk, with the chances of this happening between 10 and 15 percent, but these statistics can be altered with altered breastfeeding routines.
In a study performed on about 950 women in Zambia, over 75 percent of those who stopped breastfeeding at the four month mark had traces of the virus in their milk, whereas less than 40 percent of those who continued breastfeeding had HIV in their milk. In addition to these two groups of women, a group of mothers who alternated nursing and food supplements to provide their baby with nutrients were studied and were found to have high concentrations of HIV in their milk.
This study suggests that exclusively breastfeeding a child for over four months is the best way to minimize the risk of infection when breastfeeding with HIV. Other studies have corroborated these findings and often suggest six months of breastfeeding for HIV positive mothers. For even further precaution, mothers who take antiretroviral drugs in addition to exclusive breastfeeding will lower the risk of transmitting HIV to their children.
Many mothers do not survive childbirth, which provides another problem in terms of getting infants the nutrients they require in the first few months of life. Dr. Chris Isokpunwu, the Head of Nutrition at the Federal Ministry of Health, explains that when a child is born without a mother, a woman who is lactating and does not have HIV can nurse the baby and get it the nutrients it needs.
The new information coming to light regarding breastfeeding with HIV does not mean that the switch to breastfeeding instead of formula will be a readily accepted transition. As developing countries are struggling to make progress, the roles of women in society are shifting, meaning they are more widely employed, which makes breastfeeding a burden. Lulama Sigasana, a nutritionist working for a nonprofit organization in South Africa, explains that the government needs to implement worker policies that make it easier for women to work and breastfeed, whether they are able to go back and forth between home and work or they are provided with an area at work to breastfeed.
An additional obstacle in the transition will be the widespread misconception that formula provides children with even more nutrients than does breastfeeding. A scheme propelled by marketing companies, it is simply not true. Professor Anna Coutsoudis, who works in Durban, explains, “Mothers are not told the truth, that breast milk is infinitely better [for the infant]and that formula milk can be dangerous; that it is not always a sterile product and is easily contaminated.”
Putting these misconceptions to rest and encouraging woman to partake in breastfeeding with HIV will have myriad long-term positive effects in the future. An increase in breastfeeding will make for healthier children, fewer of which succumb to pneumonia and HIV upon entering the world, meaning that the infant mortality rate will begin to drop. Higher survival rates in a population mean decreases in population growth because parents have more of a guarantee that their children will survive, and will later contribute to society. This makes for a more stable society in general that places less of a strain on resources and has a brighter future involving less poverty and happier people.