Ask the Experts

One of HIVAN's goals is to build bridges between the different sectors of society so as to increase opportunities for sharing information and imparting knowledge around HIV/AIDS. As HIVAN is based at the University of KwaZulu-Natal, our team has access to a range of expert resources, both within our own institution and from many others in the public and private sectors.

In order to spread this knowledge, we will publish, in every edition of SONDELA, your questions, together with some form of reply from a recognised professional practitioner or researcher. In this way, the question and its answer can be shared with many readers from different parts of the province who may also need the information. If your question is confidential, there is no need for you to provide your personal details. So, for advice on HIV/AIDS, ask the experts!

In this edition, Professor Anna Coutsoudis, from the Department of Paediatrics and Child Health at the University's Nelson R Mandela School of Medicine, addresses the question of whether to breastfeed or formula-feed babies born to HIV-positive mothers:

QUESTION:

I am HIV-positive and pregnant. Even though I will have access to Nevirapine treatment during the birth of my baby, I am worried about how best to feed my baby without passing on the HI-Virus.

ANSWER:

Studies have shown that the best method of feeding your baby if you are HIV-positive is through EXCLUSIVE breastfeeding for the first six months of the baby's life, especially if you live in a poor community with little or no access to clean water.

If you use the method of MIXED feeding over a two-year period (that is, some breastfeeding and some formula feeding), there is a 15% risk of passing on the virus to your baby - if you use exclusive breastfeeding for the first six months, the risk is lowered to less than 5%.

The advantage of exclusive breastfeeding is that if your child was born HIV-positive (since even with Nevirapine treatment, about 12% of babies are born infected,) it will be healthier on breastmilk, and will take longer to develop AIDS than will a baby being fed with formula. This is because formula feeds do not contain the immune-building ingredients and antibodies that breastmilk does. Babies in poor communities are very vulnerable to diarrhoea and pneumonia, so they need the strengthening nutrients offered by breastmilk.

Guide for practising SAFE breastfeeding:

• For the first six months, breastfeed only. This means the baby must receive nothing other than breastmilk - not even water, juice or cereals etc. For the first six months of your baby's life, breastmilk contains everything s/he needs and if you feed him/her with other things, you may damage your baby's stomach and make it easier for him/her to pick up infections. Then, during the next two to four weeks, change over to formula milk and solids, or heat-treated expressed breastmilk and solids.
• Take good care of your nipples and breasts while you are breastfeeding. Place raw cabbage leaves over your breasts to help ease blocked-up breasts; this will prevent the development of mastitis, which could increase the risk of HIV transmission.
• If you have any problems with your breasts, get medical help as soon as possible. If you have sores or other breast problems on one side, express and discard the milk from that breast and feed only from the unaffected side until the breast has healed.
• If your baby develops thrush or sores in his or her mouth, take the baby to the clinic immediately for medicine to heal the mouth.
• Use condoms to prevent new HIV infection. If you become re-infected with HIV, this will increase the amount of the virus in your blood and in your breastmilk.

Send your question by post to:

SONDELA
c/o HIVAN (Centre for HIV/AIDS Networking)
University of KwaZulu-Natal, Durban, 4041
By e-mail: [email protected]
By Fax: 031 260 3169

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