HIV and infant feeding

UNAIDS/G.Pirozzi

Breastfeeding is normally the best way to feed an infant. A woman infected with HIV, however, can transmit the virus to her child during pregnancy, labour or delivery, or through breastfeeding. It is a public health responsibility to prevent HIV infection in infants and young children – especially in countries with high rates of HIV infection among pregnant women. It is also a public health responsibility to support optimal breastfeeding to prevent mortality and illness due to diarrhoea and respiratory infections.

The UN guidance takes account of the need to reduce the risk of HIV transmission to infants while minimizing the risk of other causes of morbidity and mortality which can be associated with replacement feeding. It states that "the most appropriate infant feeding option for an HIV-infected mother depends on her individual circumstances, including her health status and the local situation, and should consider the health services available and the counselling and support she is likely to receive. Exclusive breastfeeding is recommended for HIV-infected women for the first six months of life unless replacement feeding is acceptable, feasible, affordable, sustainable and safe for them and their infants before that time. When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected women is recommended."

WHO recommends that HIV-positive women who need antiretroviral treatment for their own health should have it, and this is likely to reduce HIV transmission during breastfeeding. Further studies on the safety and efficacy of this approach are awaited.

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