HIV and infant feeding

Breastfeeding, and especially early and exclusive breastfeeding, is one of the most significant ways to improve infant survival rates. However, a woman infected with HIV, can transmit the virus to her child during pregnancy, labour or delivery, and also through breast milk. In the past, the challenge was to balance the risk of infants acquiring HIV through breastfeeding versus the higher risk of death from causes other than HIV, in particular malnutrition and serious illnesses such as diarrhoea and pneumonia, when infants were not breastfed.

The evidence on HIV and infant feeding shows that giving antiretroviral drugs (ARVs) to either the HIV-infected mother or the HIV-exposed infant can significantly reduce the risk of transmitting HIV through breastfeeding. This enables HIV-infected mothers to breastfeed with a low risk of transmission (1-2%). These mothers can therefore offer their infants the same protection against the most common causes of child mortality and the benefits associated with breastfeeding.

Even when ARVs are not available, mothers should be counselled to exclusively breastfeed in the first six months of life and continue breastfeeding thereafter unless environmental and social circumstances are safe for, and supportive of, replacement feeding.