Breastfeeding + HIV is possible!

Sharing this joint statement I just received via email on the recommendations on breastfeeding, particularly for HIV-infected moms. This was published in the International Journal of Gynecology & Obstetrics.    Relevant portions on HIV provided below. 


IPA/ICM/FIGO joint statement on breast-feeding, including breast-feeding by HIV- infected mothers (June 2011)


Breastfeeding under special conditions such as HIV infection of the mother: 
In light of the changing evidence on transmission risks and recommendations on the use of anti retroviral drugs for treating pregnant women and preventing HIV infection in infants, we welcome the new recommendations on HIV and infant feeding: 

1. Balancing HIV protection with protection from other causes of child mortality 
2. Integrating HIV interventions into maternal and child health services. 
3. Setting national or subnational recommendations, based on evidence, for infant feeding in the context of HIV. 
4. Informing mothers known to be HIV infected about infant-feeding alternatives 
5. Supporting mothers known to be HIV infected who wish to breastfeed so that they can do so safely. 
6. Providing services to specifically support mothers to appropriately feed their infants. 
7. Avoiding harm to infant-feeding practices in the general population. 
8. Advising mothers who are HIV uninfected or whose HIV status is unknown. 
9. Investing in improvements in infant-feeding practices in the context of HIV 

IPA/ICM/FIGO welcome the recommendation that mothers known to be HIV infected should exclusively breastfeed their infants for the first 6 months of life, introducing appropriate complementary food thereafter, and continue breastfeeding for the first 12 months of life. Bottle feeding should be considered the best alternative only when specific conditions are met. The conditions under which bottle feeding is preferred are commonly referred to as AFASS—affordable, feasible, acceptable, sustainable, and safe—and are more specifically described in the new WHO recommendations.


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This is an interesting development, considering that current recommendation in the US CDC website is that HIV-infected mothers should not breastfeed!

Screenshot taken on 31 July 2011

Meanwhile, the UNICEF website on HIV and breastfeeding lists down factors that may decrease HIV transmission from moms to babies, including shortened duration of breastfeeding. 

Screenshot taken on 31 July 2011.

There is, however, a caveat in the recommendation:

"Bottle feeding should be considered the best alternative only when specific conditions are met. The conditions under which bottle feeding is preferred are commonly referred to as AFASS—affordable, feasible, acceptable, sustainable, and safe"

And for HIV-infected mothers in developed countries with access to clean water, they may choose to bottlefeed instead of breastfeed. 


But for countries like the Philippines, where AFASS conditions are not generally available, especially in the urban poor and rural areas, this joint statement certainly is a welcome development.