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WHO’s Recommendations For HIV and Breastfeeding

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Some timely news for World Aids Day
The World Health Organization has just issued new guidelines relating to HIV and breastfeeding. From the WHO’s press release:

In 2006, WHO recommended that ARVs be provided to HIV-positive pregnant women in the third trimester (beginning at 28 weeks) to prevent mother-to-child transmission of HIV. At the time, there was insufficient evidence on the protective effect of ARVs during breastfeeding. Since then, several clinical trials have shown the efficacy of ARVs in preventing transmission to the infant while breastfeeding. The 2009 recommendations promote the use of ARVs earlier in pregnancy, starting at 14 weeks and continuing through the end of the breastfeeding period.
WHO now recommends that breastfeeding continue until the infant is 12 months of age, provided the HIV-positive mother or baby is taking ARVs during that period. This will reduce the risk of HIV transmission and improve the infant’s chance of survival.
“In the new recommendations, we are sending a clear message that breastfeeding is a good option for every baby, even those with HIV-positive mothers, when they have access to ARVs,” said Daisy Mafubelu, WHO’s Assistant Director General for Family and Community Health.
National health authorities are encouraged by WHO to identify the most appropriate infant feeding practice (either breastfeeding with ARVs or the use of infant formula) for their communities. The selected practice should then be promoted as the single standard of care.

Tanya, at The Motherwear Breastfeeding blog, has a great post that puts this development in context. She writes:

You may recall that HIV can be transmitted from mother to child during pregnancy, childbirth, and breastfeeding. In the developing world this has been a major source of new infections.
For this reason, it’s been the recommendation that women who are HIV positive not breastfeed, as long as formula feeding is “acceptable, feasible, affordable, sustainable and safe.”
Many women in developing countries don’t have access to clean water, much less the resources to purchase formula, and not breastfeeding puts their infants at a high risk of death and disease. In one recent study of 14 developing countries, not breastfeeding resulted in over 325 deaths per 1,000 births compared to 35 deaths per 1,000 births among breastfed babies.
That’s why breastfeeding, even though it may mean that a child becomes infected with HIV, is considered safer than not breastfeeding in much of the developing world. Both feeding options carry significant risks, but a child is far likelier to die early in life if he is not breastfed.