Today is World AIDS Day. The scale of the AIDS epidemic is almost too huge to fathom: 40 million people infected worldwide, 4 million new infections this year, 12 million African AIDS orphans.
Do you know how breastfeeding and HIV/AIDS are related?
Mother-baby transmission through pregnancy, birth, and breastfeeding is a significant cause of new HIV infections. Here are a few facts about this route of transmission:
- HIV can be passed from a pregnant mother to her fetus. Antiretroviral drugs are effective at reducing the risk of infection during pregnancy.
- HIV can be passed through breastmilk. By one estimate, breastfeeding may be responsible for one-third to one-half of infant and young child infections in Africa.
So, does that mean that all HIV positive women should not breastfeed? In countries like the U.S., where formula is widely available and the water supply is safe, the answer is usually yes.
In the developing world, the solution is not as simple, and there are no good choices.
Imagine that you lived in sub-Saharan Africa. What would you do if formula was hard to find, too expensive to buy, and water supply was unsafe? What if buying formula meant that there wasn't enough money to feed the rest of the family? What if you could buy it, but diluted it to make it last long enough? Worst, what if your water supply wasn't safe, and using formula or other foods meant that your baby could die from diarrhea and dehydration?
In the developing world, the risk of death rises dramatically when babies are fed formula or other replacement foods. In one recent study of 14 developing countries, not breastfeeding resulted in over 325 deaths per 1,000 births compared to 35 deaths per 1,000 births among breastfed babies.
That's why breastfeeding, even though it may mean that a child becomes infected with HIV, is considered safer than not breastfeeding in much of the developing world. Both feeding options may ultimately mean death, but a child is likely to die earlier if he is not breastfed.
The WHO recommends formula feeding by HIV positive mothers if it is "acceptable, feasible, affordable, sustainable and safe." Otherwise, exclusive breastfeeding is recommended during the first months of life, and discontinued as soon as is feasible.
What can you do to fight HIV/AIDS? Donate to a charity that fights HIV and AIDS. Shop to benefit the AIDS Global Fund. Donate your own breastmilk to AIDS orphans through the International Breastmilk Project, which I've written about here.
