Results from a large-scale longitudinal study in South Africa have revealed the impact of HIV infections on pregnant women and the benefits of exclusive breastfeeding.

Researchers at the Africa Centre for Health and Population Studies, South Africa, have studied more than 2000 pregnant women at rural and urban sites, during pregnancy and after birth. Women who were HIV-infected were at significantly increased risk of adverse pregnancy outcomes (including stillbirths, miscarriages and antenatal maternal deaths) compared with HIV-uninfected women. Low-birthweight infants of both HIV-infected and HIV-uninfected women were at substantially increased risk of dying.

There has been much debate about breastfeeding by HIV-infected women. Breastfeeding is known to be a valuable strategy for child survival, reducing diarrhoea, respiratory illnesses and malnutrition, but there is a risk that HIV may be transmitted from mother to infant.

This study found that exclusive breastfeeding carried a significantly lower risk of HIV transmission than mixed feeding (giving breast milk plus other fluids or solids). Infants who received formula milk in addition to breast milk were nearly twice as likely to acquire HIV as infants who received breast milk only, and the addition of solids increased the risk 11-fold.

These findings have fed into the revised World Health Organization Consensus Statement on HIV and infant feeding in October 2006, which recommends that HIV-infected women who choose to exclusively breastfeed should do so for six months, while replacement feeding (e.g. formula milk) is recommended only for HIV-infected women for whom it is acceptable, feasible, affordable, sustainable and safe.

See also

• Africa Centre for Health and Population Studies

External links

• Rollins NC et al. Pregnancy outcomes in HIV-infected and uninfected women in rural and urban South Africa. J Acquir Immune Defic Syndr 2007;44(3):321–8.
• Coovadia HM et al. Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding: the first six months of life. Lancet 2007; 369(9567):1107-16.