|
|
 |
"Breastfeeding in first months reduces HIV"
Jillian Green. 02 July 2004. The Star. Republished courtesy of Independent Newspapers (Pty) Ltd.
|
HIV-positive mothers who breastfeed their infants for the first six months of life lower the chance of transmitting the virus, compared to mothers who mix-feed their babies.
Exclusive breastfeeding means providing the child with nothing but breast milk, while mixed feeding means giving the child both breast milk and formula.
According to a study done by University of KwaZulu-Natal paediatrics Professor Anna Coutsoudis, infants who received at least three months of exclusive breastfeeding had a much lower risk of transmission.
"Unfortunately we have only one published study, (but) several studies are trying to confirm this finding," Coutsoudis said.
She added that preliminary data from a study in Zimbabwe showed similar findings.
The Health Department said that while it was aware of the findings of the report, it believed all HIV-positive women should be counselled on the infant-feeding options available to them.
A paediatrics specialist within the department, Dr Ameena Goga, said they advocated two options: the complete avoidance of breastfeeding by HIV-positive women, who would then only formula-feed, or breastfeeding only for the first few months of the baby's life.
"Women need to be aware of the risks associated with breastfeeding as well as those associated with formula feeding," she said.
Coutsoudis explained that mixed feeding increases the risk of transmission because allergens and contaminants are introduced into the infant's system, "causing inflammatory processes in the gut which may allow the virus easier access".
After six months, all infants need to start receiving complementary foods in addition to breastmilk.
Available statistics indicate that, in 2002, 89 000 children in South Africa were infected through mother-to-child transmission.
Mother-to-child transmission occurs in three ways: in utero (between 5 and 10 percent), during delivery (10 to 20 percent) and by breastfeeding (10 to 20 percent).
The debate surrounding infant-feeding practices has intensified, with the Health Department proposing regulations to bar the advertisement and promotion of infant formula, follow-up formula, or any other milk product marketed as suitable for feeding an infant or toddler.
According to the Health Department, breast milk is superior for a baby's development, except when the mother is HIV-positive. And while the department promotes breastfeeding as the healthier and less costly option, it does provide free formula to women enrolled in the Nevirapine programme.
Coutsoudis said that particularly in poor communities, the chances of a baby getting a fatal bout of diarrhoea or pneumonia from contaminated water, used to mix formula feed, far outweighs the chances of contracting HIV through breast milk.
"Infant formula can prevent transmission, but it also carries its own disadvantages, according to the socio-economic background of the mother. The balance is difficult."
If a mother can afford formula feed and everything is in place to provide enough of it safely, if she is empowered enough to resist the pressure to also breastfeed and socio-economic conditions allow for it, then formula feeding is probably best, Coutsoudis said.
Coutsoudis added that in situations where a HIV-positive mother had a CD4 count of less than 200, formula feeding should be encouraged.
"If the CD4 count is less than 200, it is more likely that a child will become infected through breastfeeding," she said.
Nathan Geffen, national manager of the Treatment Action Campaign, said it was an established fact that exclusive feeding lowered the risk of infection. However, he added that the choice should be left with the woman once she had been fully counselled on the different options.
The following accepted facts highlight the dilemma. According to the Journal of Paediatric, Gastroenterology and Nutrition, breastfeeding is responsible for about 300 000 HIV infections a year.
And the United Nations International Children's Emergency Fund estimates that not breastfeeding is responsible for 1,5-million child deaths a year. |
| Was this article helpful to you? |
 ?100%???? ?0%
|
|
Back
|
|
|
|
