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HIV-Positive Mothers and Breastfeeding: Contribution of the IAEA

Exclusive breastfeeding of infants for the first six months is best for the health of all mothers and babies. (Photo: Mixed Media, Durban, South Africa)

Infants who are exclusively breastfed for the first six months of their lives are less likely to suffer from diarrhoea, pneumonia and malnutrition; have better, more resilient immune systems, and they are less prone to chronic diseases like obesity, diabetes and heart disease during adulthood.

Mothers benefit too. Those who breastfeed exclusively experience better mental health and less risk for breast and ovarian cancer.

This is true for all mothers and babies, including those who are HIV-positive.

Low Risk, High Rewards

Before 2010, the World Health Organization (WHO) discouraged HIV-positive moms from breastfeeding for fear that the disease would be transmitted to their babies. But research has since shown that anti-retroviral drugs (ARVs) given to the mother or the infant during the whole breastfeeding period were successful in almost eliminating the risk of breastfeeding transmission of HIV.

Therefore, current WHO recommendations encourage HIV infected mothers receiving ARVs to exclusively breastfeed for the first six months and then continue breastfeeding, while adding complementary foods until about 12 months of age or until they are able to safely provide a replacement for breast milk.

With IAEA support, researchers at the Department of Paediatrics and Child Health at the University of KwaZulu-Natal in South Africa have been researching HIV and breastfeeding since 2005.

Through a randomized controlled trial (RCT) under IAEA Technical Cooperation project RAF7006 Using Isotope Techniques to Assess Nutrition Intervention Programmes, equipment and training were provided so researchers could assess body composition of mothers and babies as an indicator of nutritional status, using deuterium dilution, a method involving the ingestion of water (H2O) labelled with non-radioactive stable isotopes of hydrogen (2H). The use of deuterium dilution is completely harmless.

This research, undertaken at the Cato Manor Community Health Centre in Durban, South Africa, was nested within a larger project supported by a consortium of international donors, which aimed to provide access to anti-retroviral therapy for all people living with HIV.

The research group established that breastfeeding had no negative effect on maternal health of HIV-infected mothers, but in fact it was associated with improved mental health of mothers compared to those mothers who did not breastfeed.

Research also showed that breastfed babies born to HIV-infected mothers had a reduced risk of diarrhoea, and improved growth and development outcomes compared to formula-fed babies.

The IAEA continues to support researchers at the University of KwaZulu-Natal through the African regional technical cooperation project RAF6039 Applying Stable Isotope Techniques To Monitor And Improve Infant and Young Child Nutrition In AFRA Countries, and a doctoral coordinated research project on stable isotope techniques to assess intake of human milk and body composition of infants and young children up to two years of age.

The Village is Important

Given the importance of breastfeeding, it is vital that mothers receive help and encouragement from their support system: families, healthcare providers, communities and society at large.

Meaningful support requires that these groups are well informed about breastfeeding, and that private and public spaces are conducive to nursing mothers and their babies.

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