15th Annual Conference of the British HIV Association 1-3 April 2009, Liverpool, UK

NATIONAL SURVEY OF LACTATION SUPPRESSION IN HIV-POSITIVE PREGNANT WOMEN

HIV Med 2009 Apr 1-3 (Suppl 1);15:7 (abstract no. O10)

M Pammi and EM Carlin
Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire, UK

BACKGROUND: Postnatal transmission of HIV occurs in up to 20% of HIV positive pregnant women who breastfeed. BHIVA guidelines suggest that cabergoline may be used postnatally for lactation suppression.

METHODS: We conducted a national questionnaire survey in the United Kingdom (UK) to identify whether lactation suppression is used for HIV positive mothers, method(s) used, problems experienced and awareness of the available guidance. Written questionnaires were posted to all the HIV Lead Clinicians in the UK and their responses were analysed using an access database.

RESULTS: A total of 167 questionnaires were posted and 85 responses were received (response rate 51%). Most clinics (94%) were involved in the care of HIV positive pregnant women, 58% had a specific HIV pregnancy lead, 74% ran a joint obstetric/HIV service, 70% were unaware of any national guidance on lactation suppression. All the pregnant women were advised to avoid breast feeding but only 93% of clinicians were sure that breastfeeding was avoided. One quarter of the clinicians routinely used medications to avoid breast engorgement. Of these 72% used cabergoline; 32% indicated it was dealt by the obstetricians; 47% were aware of the potential interactions between protease inhibitors and dopaminergics, 22% felt that the interactions were significant enough to avoid dopaminergics.

CONCLUSIONS: Avoidance of breastfeeding is universally advised in the UK. Use of single dose cabergoline is a simple effective method to avoid breast engorgement and its associated complications with no major drug interactions. Awareness of its potential for use in HIV positive pregnant women appears to be low. Increasing awareness of cabergoline and its appropriate use will improve the postnatal care of HIV positive mothers.

2009-04-01
O10

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