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HIV and infant feeding - what is best for babies?

26th August 1999

The risk of mother-to-child transmission of HIV presents mothers, health workers and policy makers with a dilemma and raises a number of questions. What is the best for babies, both those of infected and uninfected mothers?

Baby Milk Action has been following this issue for years, monitoring the latest research and guidelines and asking questions such as: Who funds research on HIV and infant feeding? If breastfeeding puts an infant at risk, is artificial feeding always a better solution? If infant formula is to be used, how should it be provided to prevent breastfeeding from being undermined in the general population (remember, according to WHO, 1.5 million infants die around the world every year because they are not breastfed)?

Research has found increased risk of vertical transmission through breastfeeding (research published in the Journal of the American Medical Association is currently receiving publicity). However, questions have been raised over whether truly exclusive breastfeeding has been evaluated by such studies.

Rresearch, published in The Lancet on 7th August 1999, may help to address this question. The Lancet comments: "The carefully collected information on infant feeding and the strict definition of exclusive breastfeeding enabled an assessment of risk of vertical transmission in the first 3 months by feeding method... Exclusively breastfed infants were substantially less likely to be infected at 3 months than were those receiving mixed feeding or those never breastfed... The results presented in this paper highlight the need for re-evaluation of the role of breastfeeding in transmission of HIV-1."

The topic of HIV and infant feeding has been addressed in Baby Milk Action's Update newsletter.

Please see the following recent articles:

Update 22 Baby Milk Action sets out IBFAN's concerns over new UN guidelines on HIV and infant feeding.

Update 23 Some news reports suggest that the UN guidelines call for infants of all HIV infected mothers to be bottle fed, but the guidelines clearly state: "the risk of giving replacement feeds must be less than the risk of HIV transmission through breastfeeding or there is no point in using them" .

Update 24 New research on HIV drug therapy includes breastfeeding mothers

Update 25 UN funding dilemma plus Bristol Myers Squibb offers US$100 million for AIDS programmes and says of AIDS education: " also increases sales of HIV products by developing the HIV marketplace... the returns will ultimately materialise...most of this HIV market is untapped..."

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