Breastfeeding alone cuts mother-to-child HIV transmission risk

It is widely known that breastfeeding is the most nutritious way to feed an infant. Now a new research has found that besides meeting baby's need for optimum nutrition breastfeeding significantly reduces the risk of HIV transmission from mother to the child.

Contributing to the significance of breastfeeding, scientists at the Africa Centre for Health and Population Studies, South Africa, have said that exclusive breastfeeding can significantly reduce the risk of HIV transmission from mother to child in infants aged less than six months.

Breastfeeding has been strongly recommended by the World Health Organization (WHO), however, women infected with the AIDS virus were so far advised not to breastfeed their babies.

But the South African study found HIV infected African women massively cut the risk of transmitting it to their babies when they fed them exclusively breast milk compared to those also given solid foods or replacement feed like formula, animal milk.

The recent study funded by the UK's Wellcome Trust and published Friday in The Lancet medical journal, enrolled 2,722 women, 1,372 of them HIV-positive, who gave birth between Oct. 29, 2001 and April 16, 2005 to 2,779 babies.

The team of researchers led by Dr. Hoosen Coovadia and Dr. Nigel Rollins of the University of KwaZulu-Natal in South Africa, found that infants aged between six weeks and six months fed solely on breast milk had a 4 percent risk of postnatal HIV transmission, compared to nearly 8 percent for those who in addition to breast milk also received formula or animal milk. Infants besides breast feed fed on solids during that period were almost 11 times more likely to acquire HIV.

"The question of whether or not to breastfeed is not a straightforward one," says Professor Coovadia. "We know that breastfeeding carries with it a risk of transmitting HIV infection from mother to child, but breastfeeding remains a key intervention to reduce mortality. In many areas of Africa where poverty is endemic, replacement feed, such as formula milk or animal milk, is expensive and cannot act as a complete substitute. The key is to find ways of making breastfeeding safe."

The study also found a significant surge in HIV transmission when the mother had low numbers of CD4 cells, a type of cell that play an important role in establishing and maximizing the capabilities of the immune system, and are infected and killed by the AIDS virus, in their blood.

Researchers witnessed a significant increase in the risk of transmission even amongst exclusively breastfed infants when the mother had a CD4 cell count of less than 200 per milliliter. These women were almost twice as likely to infect their infants as mothers with a CD4 cell count of 500 per milliliter.

According to Dr. Rollins, an estimated 150,000 to 350,000 infants were infected with HIV by their mothers through breast milk each year.

Sub-Saharan Africa is the worst hit region by the HIV virus. The epidemic has engulfed more than 25 million sub-Saharan Africans since the incurable disease was first emerged in 1981. Around 40 million people now live with HIV infection, most in this hardest hit region.

Sub-Saharan Africa is still bearing the brunt of the AIDS epidemic, accounting for almost two-thirds of all HIV infections and 72 percent of global AIDS deaths, the UN AIDS agency leading the battle against the disease reported in November last. A huge and disproportionate 59 percent of sub-Saharans Africans with HIV are women, the report added.

Characterized ‘breakthrough’ by medical experts, the latest findings justify that current guidelines on infant feeding in developing countries need revising.

"Based on our findings and evidence of being able to successfully support exclusive breastfeeding in HIV-infected women, and recent data from other parts of Africa, we believe that current guidelines on infant feeding warrant revising," says Professor Coovadia. "Previous reports have confused rather than guided such policies and we hope that our study will help clarify this complex issue."