Breastfeeding. AIDS and other infectious diseases

Breastfeeding has recently been recognized as a mode of transmission of certain important pathogens. It is a major mode of transmission for CMV and HTLV-1. HIV can also be transmitted by breastfeeding, but the relative role of breastfeeding in the epidemiology of HIV is still uncertain. Breastfeeding should continue to be encouraged in the HIV-infected woman, unless safe and sufficient quantities of infant formula are available. Expressed breast milk can be contaminated with bacteria or can contain viruses shed by the donor mother. Use of expressed breast milk should be carefully controlled, with strict attention to infection control issues in obtaining, storing, and processing the milk. Physicians should be aware of the risks of transmission of viral pathogens with fresh breast milk.