HIV transmission from mother to child during pregnancy, labor, delivery or breastfeeding is called perinatal transmission, which is currently the source of nearly all AIDS cases in children in the United States. HIV transmission through breastfeeding has been referred to as the “triple minority” by a World Bank economist.
The minority of the population is HIV positive. Of those who are positive, the minority infects their children with HIV via perinatal HIV transmission. And, of those whose children are infected via perinatal HIV transmission, the minority is infected via breastfeeding.
The decision about whether or not to breastfeed is a very personal one for new mothers. However, since the HIV virus is found in bodily fluid (such as breast milk) the CDC recommends that HIV infected women in the United States refrain from breastfeeding to avoid postnatal transmission of HIV-1 to their infants through breast milk.
This is the recommendation regardless of whether infected women are receiving antiretroviral therapy.
A policy statement issued by UNAIDS (the United Nations system's joint program on HIV/AIDS), whose sponsors include the World Health Organization and UNICEF, recommends weighing the rates of illness and death from infectious diseases and the availability of safe alternatives to breastfeeding against the risk of HIV transmission when recommending feeding practices.
La Leche League, an international non-profit organization that promotes knowledge and resources in support of breastfeeding, reiterates that the effects of reducing breastfeeding practices can be detrimental for child health, child survival, birth spacing and women’s health. La Leche League suggests that breastfeeding promotion is especially critical where HIV is prevalent in order to counter the possible erosion of breastfeeding practices among the vast majority of infants who are not at risk.
Accordingly, La Leche League suggests that an HIV infected mother should not breastfeed if:
(1) she is HIV positive
(2) breast milk substitutes are affordable and can be fed safely,
(3) adequate health care is available and affordable.