February 7, 2013

Even With a Suppressed Viral Load, Mothers With HIV Should Not Breast-feed

HIV-positive mothers should avoid breast-feeding, regardless of their viral load or whether they are on antiretrovirals, MedPage today reports. The American Academy of Pediatrics (AAP), which has taken a strong stance advocating breast-feeding among HIV-negative women, issued the policy statement in the February issue of Pediatrics. The position is in opposition to the World Health Organization’s recommendation for resource-poor countries, where mothers don’t have easy access to formula and where malnutrition is a primary concern.

Even if mothers have a suppressed viral load, there is still a risk, albeit a low one, of transmission to their child if they breast-feed, according to the AAP release. So long as mothers have access to clean water and affordable infant formula, the benefits of breast-feeding are outweighed by the risk of transmitting the virus, the AAP argues.

There is a higher risk of transmission if mothers are acutely (very recently) infected, or if they have mastitis or other breast abnormalities. There is also greater risk if they have a high viral load or a low CD4 count. If mothers suspect they may be HIV positive, they should not breast-feed until their HIV status has been established. To maintain their milk supply in the meantime, they can pump and then discard the milk.

To read the MedPage Today article, click here.

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