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[Breastfeeding and HIV infection]
K T Niemiec1, W Urmańska, G Kmita
1Zakład Zdrowia Rodziny IMD, Instytut Matki i Dziecka w Warszawie.
In developing countries, the benefits of breastfeeding in relation to the child's survival outnumber the risk of transmitting HIV via the mother's milk. In these countries different actions are undertaken to reduce the risk of vertical transmission during breastfeeding. On the contrary, in the developed countries HIV positive mothers are strongly recommended to avoid breastfeeding due to a high and well documented risk of transmitting the virus to a child this way. The following three important questions need to be addressed if we are to apply different interventions aimed at reducing the risk of postnatal vertical transmission of HIV: what is the rate of HIV vertical transmission through breastfeeding? When exactly can this transmission take place? What are the risk factors for HIV transmission? Although these questions are not easily answered and we only have estimates of the transmission rates, certain facts should be noted: the rate of transmission through breastfeeding is definitely high, primary HIV infection in a breastfeeding mother (postnatal infection) is related to the significantly increased risk of HIV transmission to the child, the risk of HIV transmission is almost double in the case of children breastfed for longer than 15 months.
In developing countries, the benefits of breastfeeding in relation to the child's survival outnumber the risk of transmitting HIV via the mother's milk. In these countries different actions are undertaken to reduce the risk of vertical transmission during breastfeeding. On the contrary, in the developed countries HIV positive mothers are strongly recommended to avoid breastfeeding due to a high and well documented risk of transmitting the virus to a child this way. The following three important questions need to be addressed if we are to apply different interventions aimed at reducing the risk of postnatal vertical transmission of HIV: what is the rate of HIV vertical transmission through breastfeeding? When exactly can this transmission take place? What are the risk factors for HIV transmission? Although these questions are not easily answered and we only have estimates of the transmission rates, certain facts should be noted: the rate of transmission through breastfeeding is definitely high, primary HIV infection in a breastfeeding mother (postnatal infection) is related to the significantly increased risk of HIV transmission to the child, the risk of HIV transmission is almost double in the case of children breastfed for longer than 15 months.