Why is breastfeeding contraindicated in HIV?

Understanding the Contraindications of Breastfeeding in HIV
Breastfeeding is a natural and beneficial practice for infant nutrition, but for mothers living with HIV, the decision to breastfeed is complex and fraught with significant health implications. The primary concern revolves around the potential transmission of the virus from mother to child through breast milk, which remains a critical issue in the context of HIV.
Transmission Risks
HIV can be transmitted through breast milk, and this route accounts for a substantial proportion of new pediatric HIV infections globally. In fact, studies indicate that breastfeeding can contribute to nearly 50% of pediatric HIV infections each year, particularly in regions with limited access to antiretroviral therapy (ART) and safe infant feeding alternatives. The risk of transmission is particularly pronounced in settings where mothers are not receiving effective treatment, as the viral load in breast milk can be significant.
The Role of Antiretroviral Therapy
The landscape of breastfeeding and HIV has evolved with advancements in medical treatment. Mothers on effective ART who maintain an undetectable viral load may have a significantly reduced risk of transmitting HIV through breastfeeding. Recent guidelines suggest that these mothers can be supported in their decision to breastfeed if they choose to do so. However, this is contingent upon consistent adherence to treatment and regular monitoring of viral load.
Guidelines and Recommendations
In the United States and other high-resource settings, breastfeeding is generally not recommended for HIV-positive mothers unless they are on effective treatment and have an undetectable viral load. This recommendation is rooted in the need to balance the risks of HIV transmission against the benefits of breastfeeding, which include improved nutrition and immunity for the infant. Healthcare providers are encouraged to engage in evidence-based counseling to help mothers navigate their options.
Global Perspectives and Challenges
The recommendations can differ significantly in low- and middle-income countries, where the availability of safe alternatives to breastfeeding may be limited. In these contexts, the risks associated with not breastfeeding—such as malnutrition, diarrhea, and pneumonia—can outweigh the risks of HIV transmission. Thus, the decision-making process is highly contextual, taking into account local resources, maternal health, and the infant’s needs.
Conclusion
In summary, while breastfeeding is contraindicated for HIV-positive mothers primarily due to the risk of mother-to-child transmission of the virus, the situation is nuanced. With effective ART and an undetectable viral load, some mothers may safely breastfeed. However, the decision should always be made in consultation with healthcare providers, considering both the health of the mother and the infant, as well as the resources available in their specific context.

When is breastfeeding contraindicated?

Medical Contraindications for Breastfeeding
There are a few medical contraindications to breastfeeding, and these include: An infant who has the metabolic disorder of classic galactosemia (galactose 1-phosphate uridyltransferase deficiency). A mother living with human T-cell lymphotrophic virus type I or type II.

How is HIV positive mother baby treated?

Usually, the infant should receive zidovudine syrup as 2 mg/kg/dose qid for six weeks. If the infant is premature, the dose may need to be modified. One of the most common side effects of zidovudine prophylaxis is anemia; therefore, hemoglobin should be checked at birth and at one month of age.

Can breast milk transmit HIV in adults?

Answer Breats milk do contain very tiny amount of HIV. Breast milk is infectious to a baby but is unlikely to be infectious to an adult.

Why can’t you breastfeed with HIV?

Starting in 2015, based on cumulative data demonstrating that the risk of HIV transmission via human milk is less than 1% among lactating persons who are virologically suppressed on antiretroviral treatment (ART), our clinic began supporting people with HIV to breastfeed if desired and if they were on stable …

How long can I breastfeed my baby if I’m HIV positive?

Mothers living with HIV should breastfeed for at least 12 months and may continue breastfeeding for up to 24 months or longer (similar to the general population) while being fully supported for ART adherence (see the WHO Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV …

What are the new HIV guidelines for breastfeeding?

The CDC consistent statement was that “in the United States, to prevent HIV transmission, it is recommended that mothers living with HIV not breastfeed their infants.”14 In 2023, the DHHS Perinatal HIV Guidelines were revised to include a greater focus on shared decision-making.

When can HIV not be passed from mother to infant?

If you have HIV and take HIV medicine as prescribed throughout your pregnancy and childbirth and give HIV medicine to your baby for 2-6 weeks after giving birth, your risk of transmitting HIV to your baby can be less than 1%. As long as your viral load remains undetectable, you can have a normal delivery.

What happens to babies born to HIV positive mothers?

Most infants born to HIV-positive women in the United States do not become HIV positive if the mother and infant have good prenatal and postpartum care that includes antiretroviral therapy (ART). Infants who are infected with HIV often have no symptoms for the first 2 to 3 months. Once symptoms develop, they can vary.

How does HIV spread from mother to baby?

Perinatal, or mother-to-child HIV transmission happens when a pregnant person living with HIV passes HIV to their baby. It can happen during pregnancy, delivery, and through breastfeeding.

Is it possible to sleep with an HIV positive person and not be infected?

For a person with HIV who is taking antiretroviral medicine and has an undetectable viral load, the risk of infecting someone else (or becoming re-infected) through sex is extremely low.