The issue of breastfeeding is a crucial one for pregnant women living with HIV. In many developing nations they have a tough choice: either breastfeed their babies and risk transmitting the virus through their milk, or give them formula. The latter deprives infants of the natural immunity passed on through breast milk which helps protect against diarrhoea, malnutrition and other potentially deadly diseases. Sanitation can also be an issue, with a scarcity of clean water with which to mix the formula and, in any case, many may not be able to afford to buy it in the first place. Preventing mothers from dying and babies becoming infected with HIV is one of the nine priority focus areas for UNAIDS and its Cosponsors under the Joint action for results: UNAIDS outcome framework 2009-2011.
Michel Sidibé, UNAIDS Executive Director, has championed this priority and said during a recent visit to Lesotho in Southern Africa, “Strengthened services for maternal health, for reproductive health and for paediatric health will mean we can prevent mothers from dying and babies from becoming infected with HIV in Lesotho and around the world.” The findings from the Kesho Bora study will now be considered by WHO experts, along with other recent data, and the 2006 WHO recommendations on the use of ARVs in pregnant women and on infant feeding and the prevention of mother-to-child transmission will be reviewed in the context of this new evidence. Updated guidelines are expected to be published before the end of the year.
It is clear that this research increases the range of treatment options available to mothers living with the virus and offers them hope that, if they so wish, they have a greater chance of breastfeeding their babies without passing on HIV.
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