Breastfeeding Reduces a Baby's Risk of HIV, Death, Diarrhea

On March 30, 2007, Doctors in the UN proposed changes in their guidelines about HIV+ women and breastfeeding. New research has demonstrated that nursing actually lowers the baby's risk of HIV infection. Many organizations recommend that HIV+ mothers bottle-feed their infants whenever possible, but these policies may soon change. Moreover, the urge to wait to introduce solids until six months may become stronger.

In Africa, women are more likely to supplement with formula and solids before six months than breastfeed exclusively. Breastfeeding and supplementing with solids raises a baby's risk of HIV infection eleven-fold. Supplementing with formula doubles the risk. This was true for babies of HIV+ mothers in the study, but other information tells us that exclusively breastfeeding -- just for six months -- decreases the risk for all babies.

Breastfeeding, and avoiding potentially contaminated nourishment, provides significant immunity against HIV. According to the Lancet, which published the data, nursing "ordinarily protects the integrity of the intestinal mucosa, which thereby presents a more effective barrier to HIV." This benefit of breastfeeding is also what protects breastfed babies from allergies and various other medical problems.

The study also included mothers who aren't infected. Half as many exclusively-breastfed babies died before 3 months of age as did babies receiving supplementation. Calculations suggest that this practice could decrease the number of deaths in young children by 13-15%. Not only does nursing exclusively decrease risk of HIV infection, even areas where AIDS is so prevalent, but it decreases the risk of death. Breastfeeding has long been known to strengthen and fortify the immune system, so this news is not too shocking to nursing advocates.

Generally HIV is considered a contraindication to nursing, but now that may change. Older studies, which estimated risk of transmission by breastfeeding at 10-20%, were flawed. One crucial variable was not controlled: whether or not the baby was exclusively breastfed or given supplements. Recent research, taking that factor into consideration, has shown the risk of a baby contracting HIV from breastfeeding is only 4%, maybe less. With medication and other resources, that chance is lowered to 2%.

We've had information about this since 1998, when a report demonstrated that exclusively breastfeeding may decrease the chances of HIV transmission. Another, larger trial in 2005 showed that babies given supplements before six months of age were three times more likely to become infected with HIV. A controlled study was then done by Coovadia and colleagues' where that factor was considered, producing more conclusive results: breastfeeding exclusively for the first six months of life can help prevent HIV.

Now we have more new information. The risk of exclusively breastfed babies of contracting HIV is much lower than the risk for babies whose mothers supplement, by as many as 11 times. Exclusively breastfeeding also halves the chances of early infant death in Africa. Moreover, it significantly decreases their risk of severe diarrhea. It lowers their chances of death, because it hydrates them and refuels them much better than water, formula, or cow milk. It also provides antibodies, which help them fight whatever is causing them to be sick.

Last year in Botswana, there was a diarrhea outbreak. Investigation showed that, of all babies admitted into hospitals because of diarrhea, 93% were not breastfeeding. Their chances of dying were higher. The protection against diarrhea provided by breastfeeding is a benefit that has been acknowledged for years, though not as widely as others. This is just more proof of the validity of that claim.

The UN has been petitioned to change its policies about HIV+ mothers breastfeeding. Ten years ago, the UN stated that not breastfeeding is responsible for many life-threatening illnesses. According to the UN, the risk of HIV transmission was smaller than the risk of those problems caused by not breastfeeding. A few months later, their policy was again ammended. Since then the UN has recommended formula-feeding for HIV+ mothers. They may very well soon be changing their stance yet again.

Perhaps, in light of this research, the WHO, UNICEF, and the AAP will change their stances as well. Medical professionals are now told to recommend formula for HIV+ mothers, but this may not be the case for much longer. Babies of HIV+ mothers everywhere may soon be much more likely to receive the benefits of breastfeeding. All mothers now have one more reason to wait to introduce solids until six months and to breastfeed. Once again, breast has been proven to be best--even for children of HIV-positive mothers.