HIV+ Can I breastfeed?
Q My baby is due very soon. I am HIV positive. I want to do what is best for my baby. I would like to breastfeed, but I’m finding a lot of conflicting advice on whether I should or not. Please help me. Should I breastfeed?
A LINDSAY SAYS: Congratulations on your impending arrival! Understandably, you’ll want the best for your baby, so it’s fantastic that you want to breastfeed. Before you decide whether it will be right for yourself and your baby, you’ll need to consider the following information.
Breast milk does contain HIV, so there is a small risk of transmission to your baby. While this may be the case, breastfeeding continues to provide significant benefits to both you and your baby – such as supplying your little one with the perfect balance of nutrients as well as a variety of antibodies. Breastfeeding has also been shown to reduce the risk of illnesses and disease in infants as well promoting healthy weight gain and preventing childhood obesity. Some studies even suggest that breastfed babies are smarter! For you, the benefit of uterine contraction and weight loss is a good motivator to breastfeed and return to your prepregnancy size. In addition, breastfeeding is both very convenient and free. Considering the most recent guidelines from the World Health Organization, if you do decide to breastfeed, both you and your baby will need to be on anti-retroviral treatment (ARVs).
For yourself, this will be ongoing. Your baby will need to be on ARVs until he or she is at least 12 months old. This evidence suggests that breastfeeding and ARV intervention has the potential to significantly improve an infant’s chances of surviving while remaining uninfected by HIV.
Breastfeeding will, however, need to be exclusive (that is, only breast milk) for six months, as mixing breast milk and other foods before this time increases your baby’s risk of contracting HIV. You can, however, mix-feed your baby by adding solid food or formula milk after six months. Breastfeeding is especially preferable if your environmental and social circumstances are not safe for replacement formula feeding. You would need ongoing access to sufficient quantities of the appropriate formula as well as clean, boiled water to reconstitute the milk as well as facilities to sterilise bottles and feeding equipment.
If you have access to a constant supply of ARVs, it is worth considering breastfeeding however. If you’d prefer to give formula milk for peace of mind instead, that’s okay too!
If you are still in doubt, it is best to talk to your healthcare professional to get further advice.