Breastfeeding alone cuts HIV risk

Exclusively breastfeeding until a baby is six-months old can significantly reduce the risk of mother-to-child HIV transmission, an African study says.

Breastfeeding alone cuts HIV risk

Exclusivelybreastfeeding until a baby is six-months old can significantly reduce the riskof mother-to-child HIV transmission, an African study says.

The South African researchers compared solely breastfed babies with thosealso given formula or solid foods.

They say breastfeeding carries a low transmission risk, but protects againstpotentially fatal conditions such as diarrhoea and pneumonia.

They say it is the best option for most women in the developing world.

In the developed world, the risk of mother-to-child HIV transmission hasbeen cut from 25% to under 2% because of the use of antiretroviral therapies,exclusive formula feeding and good healthcare support.

But these benefits are often unavailable in the developing world.

There, World Health Organization (WHO) guidance says HIV positive women whocan afford to use formula, and who have the facilities they need to do so -such as a fire to heat water with - should do so.

But the researchers, from the Africa Centre for Health and PopulationStudies at the University of KwaZulu-Natal, saythis is not the case for the majority of women in developing countries.

For this reason, and because exclusively breastfeeding protects againstother diseases, they suggest it is the best option.

It is also associated with fewer breast health problems such as mastitis andbreast abscesses, both of which can increase the amount of the HIV virus in themother's breast milk.

'Breakthrough'

The research, funded by the UK'sWellcome Trust, found that there was a 4% risk of postnatal transmission toinfants who were just fed on breast milk between the age of six weeks and sixmonths.

Infants who received formula milk or animal milk in addition to breast milkwere nearly twice as likely to be infected as infants who received breast milkonly.

And those given solids in addition to breast milk were almost 11 times morelikely to acquire infection.

It is thought that this higher risk is due to the larger, more complexproteins found in solid foods which may lead to greater damage to the lining ofthe stomach, allowing the virus to pass through the gut wall.

Professor Hoosen Coovadia, of the Africa Centre, said: "The question ofwhether or not to breastfeed is not a straightforward one.

"We know that breastfeeding carries with it a risk of transmitting HIVinfection from mother to child, but breastfeeding remains a key intervention toreduce mortality.

"In many areas of Africa where povertyis endemic, replacement feed, such as formula milk or animal milk, is expensiveand cannot act as a complete substitute.

"The key is to find ways of making breastfeeding safe."

Writing in the Lancet, Wendy Holmes of the Centre for International Healthin Melbourne and Felicity Savage of theequivalent institution in Londonsay the research is a "breakthrough".

"It provides crucial confirmatory evidence that when HIV-positivemothers breastfeed exclusively, their babies have only a low risk of infectionwith HIV.

"This risk is lower that that in babies who receive other food orliquids in addition to breast milk before six months."

Drs Holmes and Savage added: "The results emphasise that promotion ofexclusive breastfeeding for all mothers and babies could prevent muchpaediatric HIV infection as well as deaths from other causes."

Güncelleme Tarihi: 20 Eylül 2018, 18:16
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