Abstract

PIP: HIV can be transmitted from the mother to the baby during pregnancy, birth, or breast feeding. Around 66% of infants born to HIV-infected mothers are not infected with HIV. Most infants breast fed by their HIV-infected mothers do not become infected with HIV via breast milk, even though HIV has been detected in breast milk. Breast feeding when the mother is HIV infected does increase the risks of HIV infection for the infant but the degree of risk is not yet known. It is not easy to know if an infant is HIV positive until 12-18 months. Certain factors do increase the risk of HIV transmission during breast feeding: recent maternal HIV infection and presence of AIDS-related infections. Medical experts are so preoccupied by the risks that women receive bad advice and decide not to breast feed out of fear of transmitting HIV to their newborn. Breast feeding is an important way for mothers to assure good health for their newborns. Infants not breast fed are 14 times more likely to suffer childhood diseases than exclusively breast fed infants. Health workers must continue to support breast feeding, especially in areas where infectious diseases and malnutrition are the main causes of death, where poor hygienic conditions prevail, and where limited financial resources do not allow viable infant feeding alternatives. In such scenarios, the risk of transmitting HIV via breast milk is less than the risk of death if an infant is not breast fed. Health workers need to counsel pregnant women on breast feeding and to encourage them to consider their risk status, regardless of HIV status, so the women can make a more informed decision whether or not to breast feed. They often must provide this counseling under conditions where neither HIV testing nor infant feeding alternatives are available. Infant feeding decisions affect the whole family. Health workers should address counseling services for other family members also. Regardless of the mothers' decision on breast feeding, they need support and counseling on caring for their infant and themselves under the best conditions.