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[pronut-hiv] PanAfrica: Breast is Best - Even for Babies With HIV+ Mums


  • From: "ProNut-HIV" <pronut-hiv@healthnet.org>
  • Date: Wed, 16 Aug 2006 09:03:32 -0400

PanAfrica: Breast is Best - Even for Babies With HIV+ Mums

Health-e (Cape Town)
August 16, 2006
Anso Thom
Toronto

A South African study has conclusively shown that babies with HIV
positive mothers who are exclusively breastfed are significantly less
likely to get the virus than if they get breastmilk and other food
mixed.

Babies born HIV negative were 11 times more likely to become infected by
their HIV positive mothers if given both breastmilk and solids in their
first six months than those who were only fed breastmilk.

In addition, babies who are exclusively breastfed have a much lower risk
of death from other infectious diseases such as diarrhoea in the first
three months than those that are formula fed.

Professor Nigel Rollins, lead investigator from the University of
KwaZulu-Natal, said the problem with current government policy was that
simply giving free formula milk in many cases results in mixed feeding.

"But mixed feeding is the worst outcome being associated with increased
transmission and increased mortality. Replacement feeding, even when
exclusive is associated with increased non-infectious diseases and death
especially in the first six months," said Rollins.

The question of how HIV positive mothers should feed their babies has
been hotly contested by AIDS researchers, as HIV can be transmitted in
breastmilk.

Many of those from wealthier countries believe that HIV positive mothers
should only give their babies formula milk, but this is not practical in
places where mothers don't have clean water.

Rollins said there should be a review of government's infant feeding
policy following his study.

"As a study group we feel that women are driven or unduly drawn to
replacement feeding by the offer of free formula and that they should be
offered an equivalent 'incentive' to exclusively breastfeed such as
nutrition support to the mother herself.

"This would enable her to gain benefit herself and the child would be
protected from diarrhoea with relatively minimal risk for HIV
transmission" he said.

Rollins added that they would endorse a transition to replacement
feeding at six months if the mother has adequate support available to
feed the child safely at that time, as the risk diarrhoea was less and
the babies needed food in addition to breastmilk to grow and develop.

Meanwhile, another South African study found that mothers' decisions to
use formula milk were not based on whether she had easy access to clean
water; adequate fuel to boil water or whether she was employed or had
disclosed her HIV status.

"This means that [infant feeding] counsellors are not taking these
socio-economic factors into consideration as required in the World
Health Organistion criteria," said Tanya Doherty of the Medical Research
Council/Health Systems Trust.

The study concluded that infant HIV free survival could be improved if
women choosing to formula feed had access to piped water, fuel and had
disclosed their HIV status.

"Without these, a choice to exclusively breastfeed would result in a
better outcome," said Doherty.