For most mothers, breastfeeding is without question the best way to feed their babies. Breast milk provides all of the nutrients an infant needs during the first few months of life; it is usually readily available and costs nothing. Breastfeeding strengthens the emotional bond between mother and child and, because of its contraceptive effect, helps to control the spacing of pregnancies.

In Africa researches recently have found that, ‘Women infected with HIV who exclusively breastfeed their babies reduce the risk of transmitting the virus’. Infants who were given solids in addition to breast milk were almost 11 times more likely to become infected compared with those who had only breast milk. Infants who received formula milk or animal milk in addition to breast milk were nearly twice as likely to be infected.

In comparison, the risk of transmission to infants fed only breast milk was four percent. A trial of 958 women in Zambia found that babies who become infected with AIDS also did better and were less likely to die when they continued to breast-feed.

The WHO recommended that HIV-infected mothers exclusively breast-feed for the first six months unless substitute milk is acceptable, feasible, affordable, sustainable and safe for them and their infants.

HIV-positive mothers in well-resourced countries are advised to avoid breastfeeding because the risk of HIV transmission far outweighs the risks associated with replacement feeding. In other parts of the world, where the dangers of replacement feeding are much greater, the decision is not nearly as straightforward. Millions of HIV-positive women in developing countries face an agonising dilemma about how to feed their babies. Whichever option they choose, they are likely to face a number of difficult challenges. Over the years there has been much debate about how best to help and advise these women.

In many poor parts of Africa, formula or animal milk is expensive and cannot act as a total substitute for breastfeeding. Thatswhy Breast-feed is better option.

Breastfeeding issues

Studies have shown that mixed feeding - giving other foods or liquids as well as breast milk - should be avoided as far as possible because it substantially increases the chances of HIV transmission and death. Breast milk provides all of the fluids and nutrients that a young baby requires, so even water can and should be avoided.

Although it is not fully understood why mixed feeding leads to such a high risk of HIV transmission, it is thought likely that the extra foods and liquids damage the infant’s immature digestive system, making it easier for HIV in breast milk to enter the tissues. In addition, mixed feeding may introduce harmful germs, and may reduce gut acidity, making it easier for infections to take hold. Mixed feeding is therefore never advisable during the first few months of a baby’s life, regardless of the mother’s HIV status.

An HIV-positive mother can improve the safety of her own breast milk by expressing it into a container and submitting it to either flash-heating or Pretoria pasteurisation.

Flash-heating is achieved by placing the covered container in a pot of water and heating until the water bubbles, then removing the container and letting it cool. Pretoria pasteurisation involves boiling a small pot of water, removing it from the heat, immersing the container, covering the pan and leaving it to cool for 20 minutes. Both of these methods, if performed correctly, destroy HIV while preserving much of the goodness of the milk. However they are time consuming and require a lot of fuel. Some women may choose to compromise by using one of these methods only during weaning, when the risk of HIV transmission is likely to be greatest.

The most effective way for an HIV-positive mother to prevent her child becoming infected is to avoid breastfeeding. If HIV prevention were the only consideration then this would always be the preferred option. However, in practice, limited resources and additional health threats mean that exclusive breastfeeding is a better option for many of the world’s poorest countries. Promoting replacement feeding in inappropriate settings does more harm than good. Mixed feeding, though normal in much of the world, is never the best choice.

Via: CBC64891