Human Immunodeficiency Virus (HIV) is a virus that can be transmitted from a mother to her offspring during pregnancy, delivery or breastfeeding. However, exclusive breastfeeding (EBF) reduces the risk of mother-to-child transmission (MTCT) of HIV. But how long can a HIV-positive mother breastfeed?
Exclusive Breastfeeding and MTCT of HIV
According to the World Health Organization (WHO), mothers with HIV should exclusively breastfeed their babies for the first 6 months of life, then introduce complementary foods while continuing to breastfeed for at least the first 12 months of life. This recommendation, known as Option B+, reduces the chances of transmitting the virus to the baby.
In fact, HIV-positive mothers who exclusively breastfed their babies for the first 6 months of life had an 8.6% transmission rate compared to those who did not breastfeed, who had a 16.2% transmission rate.
The Risks of Prolonged Breastfeeding
Although EBF is highly recommended for infants born to HIV-positive mothers, there is a risk of transmission of HIV from the mother to the child through breast milk. The longer the breastfeeding duration, the higher the risk of transmission.
One study found that HIV-positive mothers who breastfed for more than 12 months had an increased risk of MTCT of HIV compared to those who breastfed for less than 12 months. The study reported a transmission rate of 21.3% in mothers who breastfed for more than 12 months and 12.9% in those who breastfed for less than 12 months.
Alternatives to Breastfeeding
In some cases where EBF may be difficult or not possible, other feeding options may be considered. Some alternatives include:
- Formula feeding: In situations where formula is available, this may be a safer option for infants born to HIV-positive mothers.
- Donor milk: Pasteurized donor milk may be used as an alternative to breastfeeding.
- Mixed feeding: If formula or donor milk is not available, mixed feeding (combined breastfeeding and formula feeding) may be considered. However, this increases the risk of transmission of HIV compared to EBF.
Conclusion
Exclusive breastfeeding for the first 6 months of life and continued breastfeeding for at least the first 12 months of life is highly recommended for infants born to HIV-positive mothers. However, prolonged breastfeeding beyond 12 months increases the risk of MTCT of HIV. In situations where EBF may not be possible, formula feeding, donor milk or mixed feeding may be considered.
