title: HIV and infant feeding in resource-rich settings: considering the clinical significance of a complicated dilemma.
abstract: With advances in the care of HIV-positive pregnant women, the likelihood of perinatal transmission is now less than 1%. In resource-rich settings women are instructed to abstain from breastfeeding, as studies have shown that breastfeeding increases the likelihood of infant acquisition of HIV. As practitioners caring for HIV-positive parents, we are now facing growing tension about the complex issues that inform decisions about infant feeding. In the face of changing guidelines and global immigration patterns, simply telling women that breastfeeding is contraindicated may no longer be good enough. We must fully open the lines of communication regarding this important and evolving issue. This commentary will review the clinical, social and cultural considerations that impact decisions regarding infant feeding in the context of HIV.
authors.affiliation: a Department of Obstetrics and Gynecology , St. Michael's Hospital , Toronto , Canada.|b Department of Obstetrics and Gynecology , University of Toronto , Toronto , Canada.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yudin
authors.affiliation: c Women's College Research Institute , Toronto , Canada.
authors.forename: V Logan
authors.initials: VL
authors.lastname: Kennedy
authors.affiliation: a Department of Obstetrics and Gynecology , St. Michael's Hospital , Toronto , Canada.
authors.forename: S Jay
authors.initials: SJ
authors.lastname: MacGillivray
mesh_terms: D001942:Breast Feeding; D003657:Decision Making; D019049:Developed Countries; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D037841:Pregnant People
keywords: AIDS; HIV; breastfeeding; infant feeding; perinatal transmission