Babies On The Breast Of HIV Moms

AIDS Retrospective Slideshow

Summary: Babies who breastfeed from mothers infected with HIV continue to be at risk for infection with HIV for as long as they breastfeed. Previously, it was thought that the risk for the baby being infected with the virus from breast milk diminished as the child grew older.(based on press release from NICHD -- National Institute of Child Health and Human Development -- of the National Institutes of Health (NIH).

Expert Perspective: "In many poor countries, mothers who are infected with HIV don't have the option of bottle feeding their infants to prevent spreading the virus to them," said Dr. Duane Alexander, head of NICHD. "This information will help us to devise new ways to help prevent infants from becoming infected with the AIDS virus." In developed countries like the United States, mothers infected with HIV are generally advised not to breastfeed their infants.

Our Comments: This is excellent research that provides information of clear value, information that is applicable to the real world. It is interesting that NIH is funding medical research primarily pertinent to poor countries But then again, it may become more pertinent to the US as the gulf between the rich and the poor grows greater. The poor in America are an undeveloped nation within our developed nation.

Barbara K. Hecht, Ph.D.
Frederick Hecht, M.D.
Medical Editors, MedicineNet.com

Analysis Shows Infants of Mothers Infected With HIV Face Nearly Constant Risk For HIV Infection For Duration of Breastfeeding

After four weeks of age, infants who breast feed from mothers infected with HIV continue to be at risk for infection with HIV for as long as they breastfeed , according to an analysis conducted and funded by the National Institute of Child Health and Human Development of the National Institutes of Health. Previously, researchers thought the risk for being infected with the virus from breast milk diminished as an infant grew older.

The analysis determined that a significant proportion of infants - 42 percent - were infected by breast feeding after they were 4 weeks old.

The study also found that infants were at greater risk for contracting the virus through breastfeeding if their mothers had low levels of CD4+ cells, an immune cell targeted by the AIDS virus. Moreover, male infants were more likely to contract the virus through breastfeeding than were female infants.

The analysis was conducted by NICHD and the Ghent Working Group on HIV in Women and Children, appears in the June 15 issue of The Journal of Infectious Diseases.

"In many poor countries, mothers who are infected with HIV don't have the option of bottle feeding their infants to prevent spreading the virus to them," said Duane Alexander, M.D., Director of the NICHD. "This information will help us to devise new ways to help prevent infants from becoming infected with the AIDS virus."

In developed countries like the United States, mothers infected with HIV are generally advised not to breast feed their infants.

The analysis pooled information from a number of studies that took place in Africa, said the NICHD author of the study, Jennifer Read, M.D., M.P.H., of NICHD's Pediatric Adolescent and Maternal AIDS Branch. Dr. Read explained that one of the greatest strengths of the study was the large number of children included in the analysis. Taken together, the number of children in the study was much larger than in any of the studies that attempted to address the issue previously. All of the studies included in the larger analysis regularly assessed the infants' feeding patterns as well as their HIV infection status, beginning shortly after birth.

For the analysis, researchers examined information on 4,085 children in 9 studies. A total of 3,025 children in the study had negative HIV test results at 4 weeks of age and were breastfed through at least 28 days of age. Of these 3,025 children, 223 had late postnatal transmission - testing negative for HIV at 4 weeks of age, but testing positive after that time. The remainder of the 3,025 children who were uninfected at 4 weeks of age did not become infected.

Late postnatal infections occurred throughout the duration of breastfeeding, with children becoming infected at any time, from when they were 4 weeks old until they were 18 months old. In all, late postnatal transmissions occurred among 42 percent of the 993 children for whom timing of HIV infection was known.

The analysis also revealed that children of mothers who had low levels of CD4 cells were more likely to become infected with HIV than were children whose mothers had higher CD4 levels.