HIV + mothers: exclusive breastfeeding recommended?

Newborns of HIV + mothers have a lower risk of infection by breastfeeding when they receive in addition to other foods, according to South African researchers who call for a review of the recommendations of the World Health Organization ( WHO) in this area.
In its recommendations updated in August 2006, WHO recommended to avoid breastfeeding in HIV-positive mothers when it is possible to use other foods, animal milk or milk powder. According to UNAIDS, more than 300,000 children worldwide are infected each year and during breastfeeding. If necessary, "exclusive breastfeeding is recommended during the first months of life," admits WHO to access these products and drinking water problems.

A countdown of the WHO, Hoosen Coovadia, University of KwaZulu-Natal (South Africa) and colleagues demonstrate in their article that exclusive breastfeeding has a better risk-benefit ratio in terms of infection and mortality when the baby receives in addition to other food, whether it is milk powder, animal milk or solid foods.

The researchers conducted their study of 1,372 HIV-positive women and their children 1405, 83% had an exclusive breastfeeding at birth, when they were only 40% in this case at the age of six months.

After six months of exclusive breastfeeding, the infection rate is only 4.04% for children who have not been infected during pregnancy.

Although they were able to measure this figure in breastfed newborns who were in addition to other foods, researchers estimate that twelve weeks of life, the risk of infection is increased by 82% compared solely breastfeeding.

"In normal situations, exclusive breastfeeding ensures the integrity of the intestinal mucosa, which [in the situation of children of HIV + mothers] might therefore be a more effective barrier against HIV," the researchers suggest.

Another possibility is a more common breastfeeding reduce the risk of breast abscesses, associated with an increase in viral load in breast milk.

Are particularly concerned solid foods that increase the risk of contamination by 10.87. According to the authors, this effect is related to the presence in them of "large and complex proteins" that damage the mucosa.

In addition to the reduced risk of infection, exclusive breastfeeding also is less costly in terms of mortality as the preferred option in the first place by the WHO that exclude any breast milk supply. The researchers show as well as three months, 6.1% of breastfed infants died, against 15.1% of those who have never been, a risk multiplied by 2.06.

According to them, these results require a revision of the WHO recommendations on the matter.