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Prevention/Epidemiology
Researchers Recommend "Safer Breastfeeding" to Minimize Vertical HIV Transmission

January 9, 2004

Several researchers have suggested that HIV-positive mothers in Africa should practice "safer breastfeeding" to minimize the risk of transmitting HIV while passing on the benefits of breastfeeding to their infants, the Toronto Globe and Mail reports. Breastfeeding passes antibodies on to infants, contributes to cognitive development and is safer than using formula, which is expensive and must be mixed with water, which could be contaminated in some parts of Africa. However, 50% of HIV-positive children in sub-Saharan Africa were infected through the breastmilk of their HIV-positive mothers, according to the Globe and Mail. After assessing the relative risks of HIV transmission through breastfeeding and contracting a disease through contaminated water, researchers have suggested that women practice "exclusive breastfeeding and abrupt weaning," in which an infant is given nothing but breastmilk for the first six months and then is abruptly cut off, the Globe and Mail reports. Researchers are unsure why this reduces the risk of HIV transmission but speculate that water, small amounts of porridge and cooking oil that are often given to infants irritate the lining of the intestines, increasing the chances that an infant's body will absorb HIV from breastmilk.

Support Needed
Women must receive support from counselors and the community to effectively practice safer breastfeeding because women can end up with breast diseases like mastitis and infants can become frustrated, leading to malnourishment, according to Katherin Semrau, project coordinator for the Zambia Exclusive Breastfeeding Study. In addition, women must be taught proper breastfeeding techniques to reduce the risk of cracked nipples and other problems that may increase the chances of HIV transmission, the Globe and Mail reports. Hoosen Coovadia, a professor of HIV/AIDS at the Nelson Mandela School of Medicine at the University of KwaZulu-Natal, found that women who adhere to the recommendations and receive proper support may have as low as a 6% chance of passing HIV on to their infants. "You can't just say, 'Don't breastfeed.' That's a death sentence for many babies. Fine, they won't get HIV, but they will die of diarrhea," Jean Humphrey, head of Zvitambo, a research project on HIV and breastfeeding in Zimbabwe, said, adding, "Safer breastfeeding is now the only real choice" (Nolen, Toronto Globe and Mail, 1/6).

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