Breastfeeding benefits may outweigh HIV risk
--------------------------------------------
http://www.scidev.net/News/index.cfm?fuseaction=readNews&itemid=3448&language=1
Angus Thomson
28 February 2007
Source: SciDev.Net
[LOS ANGELES] The benefits of breastfeeding outweigh the risks
of virus transmission from HIV-positive mothers to their
children, according to studies conducted in four African
nations.
The studies were presented at the Conference on Retroviruses and
Opportunistic Infections in Los Angeles, United States, this
week (2528 February). A study in Zambia showed that exclusive
breastfeeding - where a child is fed only breast milk - beyond a
set time period of four months did not increase the risk of HIV
transmission. The study was a collaboration between US
universities and University Teaching Hospital in Lusaka, Zambia.
Other studies suggested that continued exclusive breastfeeding
could actually improve the survival rate of HIV-positive
children.
Three studies in Malawi, Kenya and Uganda, sponsored by the US
Centers for Disease Control and Prevention, found that stopping
exclusive breastfeeding a few months after birth increased the
risk of severe diarrhoea in the infant.
The Malawi study, of over 3,000 infants, reported that the risk
of diarrhoea-related death doubled and the incidence of
hospitalisation for diarrhoea was thirty times higher if
breastfeeding was stopped early.
Speaking at the conference, Hoosen Coovadia, from the University
of KwaZulu-Natal, South Africa, illustrated the difficult
balance that must be struck.
He said that if women in developing countries were advised to
continue exclusive breastfeeding, 300,000 children would become
infected with HIV each year but 1.5 million deaths from common
diseases such as diarrhoea would be averted.
"So on the balance of probabilities for poor women in the
developing world, there is no other choice [than to continue
breastfeeding]," Coovadia said.
Many national government guidelines are based on a 2006 WHO
statement which recommends that HIV-positive women breastfeed
for six months if no alternative is available.
But Moses Sinkala, previously of the Zambian Ministry of Health,
said that the recommendations are difficult for mothers to
interpret. He said there is a need for clearer information on
the consequences of continued breastfeeding, which the Zambian
study went some way to addressing. "What we have learnt from
this study is that breast milk is more than just food for the
baby," Sinkala told SciDev.Net.