How can the risk of HIV transmission in breast milk be reduced?

  • By giving formula feeds only and no breast milk (exclusive formula feeding)
  • By giving breast milk only and no other liquids or solids (exclusive breastfeeding)
  • By preventing HIV infection of the mother (safe sex) during the breastfeeding period
  • By good breastfeeding management to avoid mastitis or breast abcess
  • By treating oral thrush correctly in the infant
  • By pasteurising breast milk. This is very helpful with pre-term infants in hospital
  • By giving antiretroviral treatment to HIV-positive mothers who elect to breastfeed

With exclusive breastfeeding, for the first 6 months, the risk of HIV transmission appears to be small. Further research is still needed to document the risk of HIV transmission with exclusive breastfeeding.

In the Durban study, which compared exclusive-breast- and exclusive-formula-feeding in HIV-positive women, the risk of HIV infection in the infant at birth and 3 months was 6% and 15% respectively in both groups. In the Harare study the risk of HIV transmission with exclusive breastfeeding between 6 weeks and 6 months after delivery was about 1%.

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