HIV-breastfeeding risk lower than previously thought

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Monday August 9 12:21 PM ET

Mixed feedings may boost infant HIV risk

NEW YORK, Aug 09 (Reuters Health) -- Results of a new study suggest that

HIV-positive mothers who breastfeed should not give their babies other foods

for the first 3 months of life.

Mixed formula-feeding and breastfeeding appears to carry a higher risk of HIV

being passed from mother to child than exclusive breastfeeding, according to

the report.

Due to the risk of HIV transmission, HIV-positive mothers in developed

countries are discouraged from breastfeeding, but in developing nations, the

risk is often outweighed by the disease-preventing benefits of breastfeeding.

Antibodies in breast milk can enhance the infant's immunity to common

bacterial infections.

In a report published in The Lancet, researchers from New York and South

Africa report on their study of 549 babies born to HIV-positive mothers

living in Durban, South Africa. The research team found that at age 3 months,

18.8% of babies who were never breastfed were HIV positive, compared with

21.3% of breastfed babies. The study results also show that 14.6% of children

who were exclusively breastfed were infected with HIV, compared with 24.1% of

infants who received mixed breast- and formula-feeding.

The investigators speculate that breast milk may contain antiviral factors

that help neutralize the virus, whereas formula may introduce allergens

and/or contaminants that may damage the infants' gut, which may increase the

risk of the baby being infected when fed breast milk from an HIV-positive

mother.

The researchers note that in African countries, where HIV infection rates are

among the highest in the world, most mothers mix breast- and formula-feedings.

``The findings open a new area of research because they raise the possibility

that exclusive breastfeeding may be a better option than mixed breast- and

formula-feeding,'' study author Louise Kuhn, an assistant professor of public

health at Columbia University in New York, told Reuters Health. ``This could

have enormous public health implications,'' she said, noting that she kept

re-checking the numbers because she was so surprised by the findings.

If HIV-positive women do not take antiviral medications during pregnancy,

there is roughly a 20% chance that their infant will contract HIV before or

after delivery, Kuhn explains. ``Breastfeeding is thought to confer an

additional 14% risk, but our findings suggest that it is not that high,'' she

adds.

Current recommendations by United Nations AIDS (UNAIDS) suggest that women

with HIV should be given all the relevant information and make their own

decision about breastfeeding.

``Until the findings are confirmed, we will continue to stick with the UNAIDS

recommendations,'' Kuhn says.

``It's premature to base public-health guidelines on the basis of the results

of this one study, and further research is urgently required to confirm and

elucidate the findings,'' writes Marie-Louise Newell an epidemiologist at the

Institute of Child Health at University College London, England, in an

editorial accompanying the study.

SOURCE: The Lancet 1999;354:442-443, 471-476.