Public Health

Breast-Feeding Can Be Worth HIV Risks In Developing World

While the majority of women in  Mozambique breast-feed their children,  Acacia Mukambe, who is HIV-positive, chose not to. Her daughter Virginia is now  16 months old, and so far has tested HIV-negative. i i

hide captionWhile the majority of women in Mozambique breast-feed their children, Acacia Mukambe, who is HIV-positive, chose not to. Her daughter Virginia is now 16 months old, and so far has tested HIV-negative.

Melissa Block/NPR
While the majority of women in  Mozambique breast-feed their children,  Acacia Mukambe, who is HIV-positive, chose not to. Her daughter Virginia is now  16 months old, and so far has tested HIV-negative.

While the majority of women in Mozambique breast-feed their children, Acacia Mukambe, who is HIV-positive, chose not to. Her daughter Virginia is now 16 months old, and so far has tested HIV-negative.

Melissa Block/NPR

In the West, HIV and breast-feeding are generally considered incompatible.

HIV-positive women are told to avoid breast-feeding all together, to give their infants the greatest chance of staying HIV-free. Not so in the developing world.

In countries that lack clean water and an affordable, reliable supply of infant formula, the World Health Organization recommends that HIV-positive mothers exclusively breast-feed their infants for the first six months.

The thinking is that the benefits — the nutrients found in breast milk and the boost to the infant's immune system — outweigh the potential risk of HIV transmission.

More than a thousand children become infected with HIV every day, the overwhelming majority through their mothers, according to the United Nations.

While antiretroviral drugs are central to efforts to prevent transmission of HIV from mother to child, counseling HIV-positive women to safely breast-feed is another strategy that's being promoted in developing countries.

It's believed that safe breast-feeding in combination with the drugs can dramatically reduce the likelihood that an infant will become infected. If the recommended regimens for both mother and child are followed, the chance of transmission falls to 5 percent in resource-poor countries, down from 30 percent to 40 percent if nothing were done.

In reality, there are many factors complicating the decisions HIV-positive women make. Some of them find it difficult to breast-feed exclusively for the first six months. Others find it hard to stop breast-feeding, as such a move would arouse suspicions among family and neighbors who might not be aware of a mother's HIV status.

On Wednesday's All Things Considered, you can hear about efforts to prevent mother-to-child transmission of HIV in Mozambique's Gaza Province, where 30 percent of women ages 15 to 49 are HIV positive.

While the overwhelming majority of HIV-positive women there do breast-feed their infants, we met one who didn't. At the urging of her husband, Acacia Mukambe never breast-fed her daughter Virginia. The 16-month-old has so far tested negative.

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