Wet nursing increases risk of HIV infection among babies

April 17, 2005

Pat Sidley, Johannesburg

BMJ 2005;330:862 (16 April), doi:10.1136/bmj.330.7496.862-b

South African children using public hospitals are exposed to HIV

infection because of a lack of infection control and because some

babies are breast fed by women who are not their mothers and who are

HIV positive, a new study says.

The study was conducted by the country's Human Sciences Research

Council, Medical Research Council, and others for the Mandela

Foundation.

It was commissioned after a previous study by the same group in 2002

found an unusually high proportion of children between the ages of 2

and 9 years infected with HIV. The suspicion had been voiced at the

time that infection during these years may have been caused by

particularly high rates of sexual abuse of children in South Africa.

However, the study's authors, Dr Olive Shisana and colleagues, say

that for ethical and legal reasons they did not look into the

possibility of sexual abuse among the children in the study. They

have instead concentrated on the possibility that HIV infection was

contracted in hospitals.

The study was conducted at several public hospitals in the Free State province

and looked at dental facilities, maternity wards, and

paediatric wards. In all these settings the researchers found that

HIV could potentially be contracted.

Nearly 30% of the milk to be fed to babies tested positive for HIV

viral RNA. Almost half (47%) of the instruments to be used clinically on

children and a quarter of instruments to be used in children's mouths and gums

had traces of blood on them.

The new finding of wet nursing as a mode of HIV transmission in South Africa

followed from the finding that 1.7% of children in the study were breast fed by

women who weren't their mothers. HIV positive children were 17 times more likely

than HIV negative children to have been breast fed by a woman other than their

mother.

HIV Risk Exposure in Children Aged 2-9 Years Served by Public Health

Facilities in the Free State, South Africa is available at

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