Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival

Abstract

EBF may substantially reduce breastfeeding-associated HIV transmission.

Post-weaning breast milk HIV-1 viral load, blood prolactin levels and breast milk volume

“…Breast milk viral load is an important determinant of postnatal HIV transmission [3,[10][11][12][13] and is associated with high plasma viral load [14,15], advanced HIV disease [16,17], and mastitis [7,10]. Increases in mammary epithelial permeability which accompanies weaning in animals [18,19] and humans [20,21] may also increase breast milk viral load.…”

“…A partial solution to this problem was suggested by the preliminary observation that exclusive breastfeeding conferred less risk of breast milk transmission than mixed feeding [2,3]. This has led to calls for early cessation of exclusive breastfeeding to provide the young infant some of the healthful immune and nutritive benefits of breast milk while minimizing the duration of exposure to HIV [3,4].…”

“…This has led to calls for early cessation of exclusive breastfeeding to provide the young infant some of the healthful immune and nutritive benefits of breast milk while minimizing the duration of exposure to HIV [3,4]. Rapid transition from exclusive breast milk to full replacement feedings might further decrease the risk of transmission by minimizing the concurrent exposure to nonbreast milk substances and HIV-containing breast milk.…”

Mothers’ infant feeding experiences: constraints and supports for optimal feeding in an HIV-impacted urban community in South Africa

“…Substantial evidence now exists illustrating the role of exclusive breast-feeding (EBF) in minimizing transmission risk of HIV while promoting child health, resulting in greater HIV-free child survival (5)(6)(7) . Recently, an African-based prospective study with feeding data on 1276 infants found a low transmission risk (4 %) following 6 months of EBF, with mortality at 3 months more than double in formula-fed babies compared with EBF infants (8) .…”

The AIDS Epidemic — A Progress Report from Mexico City

“…Seven countries have reported results (37)(38)(39)(40)(41)(42)(43)(44) from the surveillance of transmitted HIV drug resistance in geographical areas where antiretroviral therapy was first used within the country (Table 2.3). All reported less than 5% transmitted resistance to all antiretroviral drugs and drug classes.…”