HIV-positive parents OK to chestfeed if viral load is undetecable

The American Academy of Pediatrics has announced that HIV-positive parents can chestfeed their children if their HIV viral load has reached undetectable levels.

The announcement is a break from a longstanding recommendation that HIV-positive parents should not breastfeed their children, which was the guideline for 40 years. However, a report last Monday said that if the parent is receiving treatment and taking medication, the risk of the parent transmitting HIV to their baby through breastfeeding is very low, and less than 1% if the parent is undergoing antiretroviral treatment (ART).

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The study’s lead author, Dr. Lisa Abuogi, said that “the medications are so good now, and the benefits for [parent] and baby are so important that we are at a point where it is important to engage in shared decision-making,” the Associated Press (AP) reported.

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The study further said “pediatricians should be prepared to offer a family-centered, nonjudgmental, harm reduction approach.” Parents who decide to chestfeed must only do so for the first six months of their baby’s life before switching to formula or other foods because switching disrupts the gut and is thought to increase the risk of HIV infection.

The news has positive benefits for both HIV-positive parents as well as for the health of infants and parents. Chestfeeding is associated with many health benefits, including lowering parent’s risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure, among other benefits. Babies receive their parent’s antibodies from chestfeeding which can strengthen their immune systems, and lower the risk of asthma, obesity, type 1 diabetes, and sudden infant death syndrome (SIDS), according to the Centers for Disease Control and Prevention (CDC).

The American Academy of Pediatrics had said that parents with HIV should not chestfeed since the beginning of the AIDS epidemic in 1985. Chestfeeding was once the cause behind 30% of HIV infection transmissions between parent and child, the AP reported. However, ART has made drastic improvements in the reduction of HIV transmissions. Today, fewer than 30 infections occur in U.S. infants every year, according to the AP.

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