Q and A

Question

What is the safest way to feed my baby?

I am 8 months pregnant and HIV positive.

Which is the best and safest method of feeding my child once she is born?

Is breast milk ok?

Answer

Firstly, congratulations on your pregnancy.

The answer to your question depends on which country you live in. This is because different countries have different guidelines for the management of HIV in pregnancy.

In the UK, the BHIVA (British HIV Association) guidelines recommend bottle feeding.

This is because in countries where mothers can have access to to formula milk AND clean water AND bottle sterilising equipment, the risk of transmitting HIV to the baby through bottle feeding is zero.

However, in some countries mothers do not have easy access to the all the above facilities. Unless sterile water and equipment is available, the baby is at risk of other serious illnesses.

In these countries,  the WHO (World Health Organisation) guidelines recommend that if a woman is taking HIV treatment (ART), then she should breastfeed exclusively for 6 months.  After 6 months the baby can then be weaned onto a safe diet without breastfeeding.

Taking ARVs and having an undetectable viral load dramatically reduces the risk of transmission through breastfeeding.

Exclusive breastfeeding is recommended because mixed feeding carries a greater risk of transmission.

Please discuss this with your doctor so you understand the recommendations where you live.

Are in contact with support groups for people living with HIV? I ask because many women find it helpful to share experiences and ways of coping with being positive and pregnant.

If you live in the UK, you may also find it useful to contact Positively UK, an organisation who support families living with HIV. They will put you in touch with an HIV positive “mentor mother”. Mentor mothers are HIV women who have had children and who can support you through your own pregnancy.

Good luck for the rest of your pregnancy and with the delivery.

This answer was updated in January 2016 from a question first posted on 17 April 2012.

52 comments

  1. Lisa Thorley

    Hi Lorraine,

    Have you had your baby tested? Did they take medication when they were born? What was your viral load when you gave birth?

    With regards to your specific question its not possible to say if your baby will be negative or not. This is why testing is important.

    Ideally if a women is going to breastfeed her viral load should be undetectable. However, if the options to formula are limited, the breastfeeding is recommended. For more info about this, please see here:

    http://apps.who.int/iris/bitstream/10665/246260/1/9789241549707-eng.pdf?ua=1

  2. lorraine

    Hey my name is Lorraine, I’m hiv+ and breastfeeding. I find out I was + in 5months during my pregnancy and started to take ARV’s, my viral load was way high, now it’s 76. Would my baby be infected?