Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
Reuters NewMedia, Inc.; Friday August 21, 1998
Dr. Valeriane Leroy of Universite Victor Segalen Bordeaux in France, and colleagues pooled data from four studies conducted in developed countries and four studies in developing countries that followed infants born to HIV-positive women. They examined data for infants who were HIV-negative at birth.
Leroy's group found that less than 5% of the infants born to HIV-positive women in developed countries were breastfed, and none of these infants were infected with the virus in the postnatal period.
But in developing countries, most HIV-infected mothers breastfed, and "postnatal transmission occurred in 49 (5%) of 902 children in four (study groups)," the researchers write. For these infants, the team calculated that if breastfeeding had been halted by 4 months, no HIV transmissions would have occurred. And if breastfeeding had been halted by 6 months, only 3 HIV transmissions would have occurred.
Based on these findings, they suggest that "the risk of acquisition of HIV-1 through long-term breastfeeding may outweigh its benefits in populations with high prevalences." Additional research is needed, they add, to determine the risk and timing of postnatal HIV transmission through breast milk and the net effects of stopping breastfeeding on the health and survival rates of these infants.
Breastfeeding has demonstrated benefits for both infants and mothers, including reduced infant mortality and maternal fertility. But breastfeeding may double the risk of HIV transmission from mother to child, according to previous reports. "Avoidance of breastfeeding by HIV-1-infected women is recommended if safe and affordable alternatives are available, a practice reinforced by WHO, UNICEF, and UNAIDS," Leroy's team note.
SOURCE: The Lancet 1998;352:597-600.
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