HIV/AIDS-Infected Mothers Q&A

Published by IFM

Should an HIV/AIDS-infected mother breastfeed her child?

Only a health care professional can make this type of recommendation, and it should be made in conjunction with international health policy.

In 2006, WHO issued a statement that the most appropriate infant feeding option for an HIV-infected mother should continue to depend on her individual circumstances, including her health status and the local situation such as the health services available and the counseling and support she is likely to receive.

HIV/AIDS and infant feeding is a complex issue. There are still significant knowledge gaps and more research is needed. As recommended in various health policies and strategies by UN agencies, (e.g., UNICEF, UNAIDS, WHO), mothers should be empowered to make a fully informed choice about infant feeding choices and be supported in implementing their decisions.

According to the recommendations of the WHO Technical Consultation on the Prevention of Mother to Child Transmission of HIV, when replacement feeding (e.g., infant formula) is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life.

The WHO has recently updated its HIV/AIDS infant feeding guidelines, which are currently under scientific review. IFM member companies support WHO guidelines and welcome further collaboration on initiatives with governments, health authorities and international health agencies to help prevent further transmission of HIV/AIDS.

The WHO Consensus statement of October 2006 states:

• The most appropriate infant feeding option for an HIV-infected mother should continue to depend on her individual circumstances, including her health status and the local situation, but should take greater consideration of the health services available and the counseling 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.
• When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected women is recommended.

There is no doubt that breast-milk can transmit HIV. Scientific studies have shown that the risk of transmission varies between 15 percent and 30 percent among infants who are not breastfed. The risk of HIV transmission among breastfed babies increases to between 25 percent and 45 percent. Rates of mother-to-child transmission range from 14–25 percent in developed countries and from 13–42 percent in developing countries.

There is continued concern that up to 20 percent of infants born to HIV-infected mothers may acquire the infection through breastfeeding, depending on the duration and other risk factors. In women who are not treated for HIV/AIDS and who continue to breastfeed after the first year, the absolute risk of transmission through breastfeeding is 10–20 percent.

The WHO has issued recommendations intended to discourage women infected with the

AIDS virus from breastfeeding. This much-debated step aims at preventing transmission of HIV, the AIDS virus, from mothers to babies in what UN officials say is "a runaway epidemic" in many developing countries. I understand that you offer HIV/AI DS mothers free infant formula in the hope that they start buying it down the road.

Is the industry exploiting the AIDS crisis in order to make more money?

No, IFM member companies are not exploiting the AIDS crisis. We adhere to the WHO Code of Marketing Breast-Milk Substitutes. In accordance with this Code, IFM member companies comply with national restrictions on distributing free samples to hospitals or health care professionals. Government decision-makers are responsible for determining whether and under what conditions free or subsidized infant formula will be offered. These officials are responsible for establishing policies on procurement, distribution and monitoring.