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By Hlulani Masingi 

As we enter the festive season and acknowledge World AIDS Day on 1st December, many mothers might be wondering how safe breast milk is. Independent Midwifery Consultant and Researcher, Dr Diana Du Plessis, answers your questions.

Q              I’m HIV Positive And Expecting. Can I Breastfeed?

Yes. HIV positive mothers are encouraged to breastfeed, but should not default on their antiretroviral medication and vitamin supplements. If the mother is HIV positive, the newborn will receive anteretroviral medication. HIV is transmittable through breast milk; however, the risk for transmission to the infant is extensively reduced if the mother continues her medication.

More babies die from malnutrition and diarrhoea when bottle-fed due to lack of safe water and lack of finance to make up the feed correctly. The risk for mother-to-child HIV transmission (MTCT) is increased with the severity of immune deficiency. Women with a low CD4 count are more likely to transmit HIV to their infants, the more advanced the HIV disease, the higher the risk of MTCT.

Q              Should My Baby’s Results Come Back Positive, Could I Continue Breastfeeding?

The mother should exclusively breastfeed for the first six months with no water, rooibos, juice or maize given, as this will increase the risk for the virus to take hold. Furthermore, HIV-positive infants should be breastfed for the first two years in addition to solids after six months of exclusive breastfeeding.

Q              Does The Government Offer ART To HIV-Positive Mothers Who Are Breastfeeding?

Yes. The mother is entitled to ARV therapy, whether she is breastfeeding or not, pregnant or not. The government made a commitment to her (as a vulnerable person) in the constitution that she receives a life-long medication free of charge at various clinics or hospitals.

Other Options Available For HIV Breastfeeding Mothers Include The Following:

  • Expressing and pasteurisation of breast milk.
  • Expressing and flash-heating the breast milk.
  • Choosing to formula-feed – the criteria to determine the mother’s ability to rather formula feed include AFASS, broken down as follows:
  1. Acceptability: Are there any barriers to choosing to bottle feed – culture, social reasons, fear of stigma and discrimination?
  2. Feasibility: Does the mother have the knowledge, skill and resources to prepare the formula?
  3. Affordability: Can she afford it (formula, equipment, clean water) and still not compromise the health and well-being of the other family members?
  4. Sustainability: Can she sustain this method of feeding for at least 2 years, and if the infant is HIV positive or much longer?
  5. Safe: Does she have clean housing conditions, safe water, clean and sterile equipment and utensils?

Phillips AVENT supports the HIV pregnant women by donating breast pump to hospitals and by playing an active role in the continuous professional development of midwives regarding their responsibility to breastfeed exclusively for the first 6 months.

 
Image: My Brown Baby

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