Photo by Iain McLellan for AED, FANTA Project  

[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]

[pronut-hiv] Nutrition & care for HIV positive infants/Heat-treated expressed breastmilk

  • From: Pamela Morrison <>
  • Date: Thu, 6 Feb 2003 14:14:27 -0500 (EST)

Nutrition & care for HIV positive infants/Heat-treated expressed breastmilk

Further to the discussion on feeding the babies of HIV-infected mothers,
one option which has not yet been discussed is the use of the mother's own
pasteurized breastmilk. I am pasting below a short piece I have recently
developed showing how mothers could use their own milk for their babies,
while simultaneously avoiding any risk of post-partum transmission of the
virus to their babies through breastfeeding.

Pamela Morrison
International Board Certified Lactation Consultant



CURRENT INTERNATIONAL HIV AND INFANT FEEDING GUIDELINES suggest that when children born to women living with HIV can be ensured uninterrupted access to nutritionally adequate breast-milk substitutes that are safely prepared and fed to them, they are at less risk of illness and death if they are not breastfed. It is considered that milk in some form is essential, and replacement feeding options include commercial infant formula, and home prepared formula which can be made from animal milks, typically from cows, goats, buffaloes or sheep (UNAIDS 1998). However, the possibility that mothers could use their own treated breastmilk as a replacement for
breastfeeding directly has received scant attention.

A study conducted in 1993 (Orloff et al) for the Human Milk Banking
Association of North America established that HIV in breastmilk could be
inactivated by Holder pasteurization (heating to 62.5 degrees C for 30
minutes). Dr Caroline Chantry and colleagues published a paper in 2000
describing a small study conducted in Puerto Rico to examine virus in the
expressed breastmilk of a small number of HIV+ mothers. Although HIV
could be identified in the milk of 88% of the women, it could not be
recovered from any of the samples after flash-boiling (bringing breastmilk
just to boiling point, so that bubbles appear around the edge of the pan).
(Chantry 2000). In 2000 and 2001, Dr Bridget Jeffery in Pretoria described
and researched another method of home-pasteurization which could be
employed using very simple implements available in the homes of ordinary
women living in resource-poor settings. (Jeffery et al 2000, and
2001) The Zimbabwe Ministry of Health officially presents the use of
expressed breastmilk as a primary option to be considered by HIV+
mothers (Zimbabwe Ministry of Health 2000)

PASTEURIZATION OF BREASTMILK AT HOME, using simple equipment, is not only safe, but possible. Home-heated expressed breastmilk is the most logical feeding alternative for those women who wish to avoid any possibility of transmission of the virus to their babies by breastfeeding, yet wish to provide them with the most physiologically suitable milk for human
infants. The mother who provides her own milk for her baby has absolute
control over her own milk supply and can assure her baby's food security
for the whole time that she lactates. Heat-treated EBM is nutritionally
superior to other replacement feeds, maintains some immunological
protection, avoids the risk of allergy, and costs nothing. In addition,
the hormonal impact on a mother who continues to lactate is likely to
result in less stress, increased enjoyment of her baby and longer
lactational amenorhhea, which contributes to a longer interval before the
birth of the next child.

Prepared in January 2003 by:
Pamela Morrison
International Board Certified Lactation Consultant
10 Camberwell Close

ProNut-HIV is a collaboration between SATELLIFE and the Academy for
Educational Development (AED).

To send a message to ProNut-HIV, write to:
To subscribe or unsubscribe, write to:
in the body of the message type: subscribe pronut-hiv OR unsubscribe
To contact a person, send a message to:
Information and archives: