Should I Breastfeed or Not?: The Dilemma of HIV Infected Mother

Tuesday, 8 July 2008: 8:50 AM
Zohra Kurji, BScN, RN, IBCLC , School of Nursing, Faculty of Health Sciences, Aga Khan University, Karachi, Pakistan
Shehnaz Rashid, BScN, RN, IBCLC , Lactation Clinic, Maternal and Child Health Center, Sharjah. Ministry of Health, UAE, Sharjah, United Arab Emirates
Zahra Shaheen, BScN, RN, IBCLC , Catco Kids, Inc, Catco Kids Inc, Karachi, Pakistan
Yasmin Murad Mithani, RN, RM, BScN, IBCLC , School of Nursing, The Aga Khan University School of Nursing, Karachi, Pakistan

Learning Objective 1: : Discuss the collaborative role of lactation consultants and counselors in counseling women with HIV on breastfeeding concerns.

Learning Objective 2: Discuss strategies on breastfeeding and alternate feeding options that maximizes the child's potential while minimizing the risk to HIV infection and associating health problems

According to the existing global healthcare scenario on HIV infection, more than half of the 40 million people HIV infections are women. Consequently the mother to child HIV transmission also has increased by 15%. Studies have shown that it is transmitted to about 14% of infant born to HIV- infected mothers and that the likelihood of HIV transmission through breastfeeding is 2.2 times more by these mothers. Considering the many benefits of breastfeeding for mother and infant, WHO and health professionals worldwide are striving to empower mothers to breastfeed successfully. However, whether HIV infected mothers should breastfeed their child or not remains a dilemma based on evidence which supports that in poor developing countries artificial milk feeding triples the risk of infant death due to infectious diseases and suggests that it is safer to exclusively breastfeed even when the mother is HIV positive.

Relating to the dilemma, this paper aims to discuss lactation consultants' and counselors' role in collaboration with government and healthcare agencies to counsel these women by providing accurate and complete information on disease transmission through breastfeeding when it is inevitable due to lack of resources and risk of infectious diseases, and by suggesting alternate feeding options that are safe and economically feasible specifically exclusive formula feed feeding in this case. It is therefore important to empower these women through education and counseling in order for them to make informed decision about infant feeding; and support their decision by providing hygienic environment, safe water and sanitation when substitute to breastfeeding is used.