HIV and Breastfeeding1
Risk of mother-to-child transmission
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Without treatment, about a third of HIVinfected mothers pass the virus to their
newborns during pregnancy, delivery, and
breastfeeding.
In the absence of any interventions,
approximately 16 percent of infants born to
HIV-infected women will be infected through
breastfeeding.
HIV transmission may continue for as long as
a child is breastfed.
Among women recently infected with HIV,
the risk of transmission through breastfeeding
is nearly twice as high as for women infected
before or during pregnancy.
Women with HIV face the dilemma of choosing the right infant feeding option in
trying to prevent HIV transmission to their infants while not exposing them to the risk
of malnutrition and other illnesses due to not breastfeeding.
Health risks for non-breastfed infants
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Not breastfeeding, compared with any breastfeeding, has been shown to expose
children to an increased risk of malnutrition and life-threatening infectious
diseases other than HIV, especially in the first year of life.
Exclusive breastfeeding appears to offer greater protection against disease than
any breastfeeding.
In developing countries, as many as 54 percent of all deaths among children under
the age of five are associated with malnutrition.
In developing countries, not breastfeeding during the first two months of life is
associated with a six-fold increase in mortality due to infectious diseases. This
increased risk drops to two-and-a-half-fold at six months, and continues to
decrease with time.
Types of Infant Feeding
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Exclusive breastfeeding
Means the infant has received only breast milk from the mother or a wet nurse, or
expressed breast milk and no other liquids or solids with the exception of drops or
syrups consisting of vitamins, mineral supplements, or medicines.
A child may be exclusively breastfed with expressed human milk from the mother, a
breast milk donor, or a milk bank.
1
Adapted from HIV and Infant Feeding, WHO, 2003.
August 2005
Contraception for Women and Couples with HIV
Fact Sheet 8
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Replacement feeding
Means the process of feeding a child who is not receiving any breast milk with a diet
that provides all the nutrients the child needs. During the first six months, this should
be with a suitable breast-milk substitute — commercial formula, or home-prepared
formula with micronutrient supplements. After six months, it should preferably be
with a suitable breast-milk substitute, and complementary foods made from
appropriately prepared and nutrient-enriched family foods, given three times a day. If
suitable breast-milk substitutes are not available, appropriately prepared family foods
should be further enriched and given five times a day.
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Partial breastfeeding or mixed feeding
Means giving a baby some breastfeeds and some artificial feeds, either milk, cereal, or
other food.
Breastfeeding options for women with HIV
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When replacement feeding is acceptable, feasible, affordable, sustainable and safe,
avoidance of all breastfeeding by HIV-infected mothers is recommended.
In the absence of a safe alternative to breast milk, exclusive breastfeeding is
recommended during the first six months of life.
Mixed feeding with both breast milk and other feeds has been associated with a
higher risk of HIV infection for the infant than exclusive breastfeeding and should
be avoided because it increases the risks of both HIV infection and the risks
diarrhoea and other infectious diseases.
To make the best choice, HIV-positive women should
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Receive counselling that includes information about both the risks and benefits of
various infant feeding options.
Receive guidance in selecting the most suitable option for their situation.
Have access to follow-up care and support, including family planning and
nutritional support.
August 2005
Contraception for Women and Couples with HIV
Fact Sheet 8