The breast-feeding dilemma and its impact on HIV-infected women and their children.
The rate of HIV transmission via breast-feeding ranges from 14% to 26%, depending on the timing of maternal infection. In settings where infant mortality rates from infectious diseases and malnutrition are low and relatively safe alternatives to breast-feeding are available, HIV-infected mothers should be advised not to breast-feed. Where breast-feeding by HIV-infected mothers and bottle-feeding both present serious risks of mortality, changing the conditions in which families live so that safe feeding alternatives become available must be a top priority. At the same time, these mothers need information about the relative risks and benefits of breast-feeding, early weaning, wet-nursing, and formula feeding. This article reviews the available research data and discusses critical gaps in current knowledge.
Department of Health and Social Behavior, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
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D001903:Bottle Feeding; D001942:Breast Feeding / Q000009:adverse effects*; D037001:Directive Counseling; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D012307:Risk Factors; D013997:Time Factors; D014886:Weaning