title: Care of the HIV-exposed child--to breast feed or not?
abstract: Breast milk is the best form of nutrition for infants. However, it places infants born to HIV infected women at risk of acquiring HIV infection. Total avoidance of breastfeeding is the only way of completely avoiding HIV transmission through breast milk. However, this strategy has not proved to be viable in resource constrained nations. A high infection related mortality and morbidity, and a high prevalence of malnutrition have been observed in HIV exposed infants on replacement feeding. Exclusive breastfeeding for the first six months followed by rapid weaning has also not proved to be a good strategy, with a surge in infection related morbidity and malnutrition reported after weaning. Current evidence indicates that continued use of ARV prophylaxis to mother/infant starting during pregnancy and continued to cover the entire duration of breastfeeding offers the infant best chance of HIV free survival, combining the benefits of breast milk with safety induced by ARV prophylaxis.
authors.affiliation: Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110001, India. anjuseth.peds@gmail.com
authors.forename: Anju
authors.initials: A
authors.lastname: Seth
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001942:Breast Feeding; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000821:virology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents