Breast feeding,breast milk and AIDS

In response to concerns that breast milk can transmit human immunodeficiency virus (HIV) infection, the International Planned Parenthood Federation (IPPF) Acquired Immunodeficiency Syndrome (AIDS) Prevention Unit has developed a series of recommendations. A total of 5 infants have reportedly become infected as a result of breastfeeding when their mothers became infected with HIV in the immediate postpartum period. However, there are even more cases in which women in similar circumstances breastfed their infants and HIV infection was not transmitted. The infectivity of breast milk is probably dependent on factors such as the frequency or timing of appearance of HIV in breast milk, the viral titer, the mother's nutritional and immunologic status, maternal exposure to other viruses, parity, and the integrity of mucosal barriers. In addition, there are possible protective effects of breastfeeding, including reduction of the incidence and severity of diarrhea and gastrointestinal infection; reduction of the infection load and possible protection against the progression of HIV-related diseases; and the essential immunologic, nutritional, childspacing, and emotional benefits to the child. For all these reasons, it is recommended that breastfeeding by the biologic mother should be the feeding method of choice regardless of her HIV antibody status. If the mother cannot breastfeed, the use of pooled or alternative sources of human milk should be considered. In addition, further research is required to determine whether antibody in breast milk is protective and the factors that affect secretion of HIV in breast milk.