Preliminary Research Gives New Hope to HIV-Positive Mothers

For new mothers, breastfeeding babies are the best way to nourish them and protect them against malnutrition, common colds and airborne viruses. But for new mothers living with HIV, breastfeeding comes with the ever-present fear of transmitting the virus to their babies. For now, mothers with HIV have the option to not breastfeed or to breastfeed for a little while to prevent the spread of HIV to their babies.

But to end the risk of HIV transmission through breastfeeding, researchers theorize that feeding infants a freeze-dried formula of good bacteria before breastfeeding could destroy HIV in the breast milk babies will receive. They hope to destroy or effectively block the HIV in breast milk with a friendly bacterium found in the mouth known as lactobacillus. Lactobacillus is also found in yogurt and in kefir.

Dr. Marc Siegel, an associate professor at the New York University School of Medicine believes lactobacillus could very well be a breakthrough in ending mother-to-infant HIV transmission. Dr. Siegel said lactobacillus can block HIV and prevent it from entering mammalian cells because HIV, while deadly as a disease, is relatively weak as a virus. This provides good news for research in its preliminary stages that has not yet been tested in humans.

How Lactobacilli Would Work

Researchers suggest that Lactobacilli could be given to infants either in formula or as a type of lollipop. The friendly bacterium would then be ingested and once ingested, the bacterium will colonize the infant's GI tract where it would capture the HIV.

The advances in ending mother-to-infant HIV transmission through breastfeeding seems promising, especially in developed countries with access to refrigeration that would keep the bacteria active so it can counter the HIV. However, the freeze-dried formula would prove a bit of a problem when it came to protecting infants in areas such as Africa and less developed countries with no access to refrigeration. For this reason, Drs. Tin Loa, an associate professor in the department of oral biology at the University of Illinois at Chicago, and R. Chang from Lavax, Of Palatine, Ill, developed a new freeze-dried technique for keeping lactobacilli active even in hot temperatures. With this new freeze-dried technique, once the bacteria colonize the GI tract, infants are fed milk to keep the bacteria active and enable them to destroy the HIV in the breast milk. Lactobacilli were tested at varying temperatures to ensure that the bacteria remained viable to block the HIV and the results were good; the bacteria remained active through varying stages of heat.

Mother-to-infant HIV Transmission on the Decline

Between 2000 and 2006 researchers collected data from 5151 HIV positive pregnant women in the UK and Ireland and found that only 1.2 percent of infants born to HIV positive mothers contract the virus from their mothers when the mothers follow the recommended precautions and take effective antiretroviral therapy (ART). The results were published in the journal, AIDS. The findings included all aspects of mother-to-infant transmission including the birthing process and breastfeeding.

Alternatives to Breastfeeding for HIV-Positive Mothers

Mothers with HIV have been known to be fearful of breastfeeding their children. In fact, the World Health Organization (WHO) states that the longer an HIV -positive mother breastfeeds her baby, the more likely she can pass the virus onto her child. Therefore, the WHO recommends that: "breastfeeding should be discontinued as soon as feasible, taking into account local circumstances, the individual woman's situation and the risk of replacement feeding (including infections other than HIV and malnutrition).

As a result of all these risks to the child, HIV-positive mothers have found alternative ways of providing the needed nutrients to their babies. One alternative is to employ a wet nurse, who is HIV-negative to breastfeed the baby. There has been suspected cases of wet nurses being infected with HIV through breastfeeding by an infant whom was believed to be HIV-negative.

Another alternative to breastfeeding for HIV-positive mothers is to feed their babies with donated breast milk, from milk banks. Breast milk banks are popular in countries such as Brazil and if the milk is properly pasteurized it carries not particular threat of HIV infection.

Also, HIV-positive mothers have the option of extracting their own breast milk and having it submitted to flash-heating or Pretoria pasteurization, which have been known to kill the HIV without compromising the nutrients in the breast milk.

The decision to breastfeed as an HIV-positive mother is a complicated one. HIV-positive mothers should consult their doctors to work out a solution that suits their situation and circumstance. But hopefully, researchers of the freeze-dried technique will be able to make the difficult decision to breastfeed while living with HIV a thing of the past.

Source: Discovery Health News, Freeze-Dried Formula May Block HIV Virus in Breast Milk, retrieved July 11, 2008.

Medical Research Council, 99 percent of children born to HIV positive mothers uninfected, retrieved July 12, 2008.

Avert, Overview of HIV and infant feeding , retrieved July 14, 2008.