InterPress News Service (IPS); Friday, 4 October 1996.
Isabella Matambanadzo

"It is nutritionally balanced. It is a delicious (sic) food and drink with a perfect combination of liquids and nutrients. It is a wonder drug that both prevents and treats diseases in the short and long term. (And it) Has no 'best before' limitation...," the poster reads.

But in light of ongoing research which indicates that the Human Immunodeficiency Virus (HIV) can be transmitted to babies through breast milk, some mothers may be inclined to break what has become in Zimbabwe (and the rest of Africa) a golden rule: Thou shalt breast-feed.

"It is a fact now that HIV is transmitted through breast milk. There are no two ways about it," said Elizabeth Matenga, executive director of the AIDS Counselling Trust (ACT).

"Whereas one or two years ago there was no conclusive evidence, now (there is proof that) the milk is infected with HIV. It is no longer safe for the child...," Matenga added.

New research in South Africa indicates that HIV, which causes the Acquired Immune Deficiency Syndrome (AIDS), can be transmitted to babies through the mothers' milk.

"...It seems strange how something as good and beautiful as mother's milk can be dangerous," said South African paediatrician Dr Glenda Gray.

Dr Gray of Baragwanath Hospital, just outside of the sprawling black township of Soweto near Johannesburg, carried out a study on some 102 HIV positive mothers.

Forty-nine women fed their babies infant formula. Only 17 percent of these children tested HIV positive. The infants might have been infected in the womb or during birth, Dr Gray said.

The other 53 women breast-fed and 38 percent of their children were HIV positive. The results suggest that breast feeding increases by about 21 percent the risk of passing HIV from mother to child through milk, Dr Gray said.

"Transmission in Africa is about 25-40 percent. In Europe, it is 15-20 percent. This is because a lot of our mothers breast feed and we have a virulent strain of the (HIV) virus. In our setting women who breast feed have two times more risk of transmission," explained Dr Gray.

Since there is no conclusive evidence however on breast milk and HIV transmission, the issue is still a controversial one here.

"I am unhappy with the data that incriminates breast milk. We need more research," commented a doctor who declined to be named.

The two strongest points for breast milk are: women from poor or low socio-economic backgrounds cannot afford the high cost of infant formulas, bottles, and the fuel needed to boil water; and according to the United Nation's Children's Fund (UNICEF), about 1.5 million children die annually from inappropriate formula feeding.

"There are a lot of unknowns about when or at what stage HIV is transmitted through breast milk; some mothers do not even know they are HIV positive," Dr Geoff Foster, the director of the Family AIDS Caring Trust (FACT) said.

ACT's executive director Matenga said developing countries like Zimbabwe "have to weigh the two evils, breast milk and baby formula".

If the verdict is to continue breast feeding because formulas are expensive and can lead to death if not properly prepared, then the cost of caring for a child who may contract HIV has to be weighed against the cost of infant formula in the long run, Matenga said.

It is not just the health care costs, but also the "more expensive psychological cost to the mother," Matenga added. "She is sick and has to look at her sick child. What is kinder to the mother? What is the best way forward?"

Infant formula is an option, but the cost is a barrier, unless a government provides subsidies. In Zimbabwe, for example, it costs 2,500 Zimbabwean dollars (250 U.S. dollars) per year to feed a child on the least expensive formula on the market.

"Early weaning, pasturising the milk, providing vitamin A supplements, inspecting the baby's mouth and the breasts to see if there are any cuts or a rash all lowers the risk of transmitting HIV to the baby," Dr Gray explained.

Any solutions also have to be low cost, accessible and easily manageable for poor mothers in the rural areas. And, the governments must begin to play a more active role in ensuring that women get the correct information.

"The problem is the governments have not come out with clear information....They are not concerned about the consequences of continuing to breast feed a child. We have to put pressure on them to provide mothers with proper information..." (end/ips/im/pm96)

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