Q and A

Question

I’m detectable and breastfeeding, is there a risk?

If my viral load is detectable and I’m breastfeeding is my baby at risk? My baby is on medication.

Answer

Thanks for getting in touch.

Guidelines relating to breastfeeding and HIV positive mothers vary depending on where a woman lives globally. In the UK breastfeeding isn’t advised and this is even when someone has an undetectable viral load.

If a woman who is positive is breastfeeding when their viral load is detectable, then yes there is a risk of transmission. This is even if the baby is on medication. As to the level of risk its not possible to say. If in doubt the best and safest option is to give a baby formula.

19 comments

  1. Jane

    Hi. I am worried. I am HIV positive. Undetectable. I have a 4 weeks old baby and breastfeeding. I have symptoms of mastitis in my right breast for a week now. But I still breastfeed my baby. I recently read that it could risk my baby having hiv. Now I am worried. Is there any chance that my undetectable status and baby on prep could eliminate hiv.

  2. Roy Trevelion

    Hi Thozama,

    Many congratulations on the news that you’re going to hav another baby. It’s great that your 2 year old little girl tested HIV negative. It shows that you’re doing the best you can.

    It’s important to know that if your HIV is well managed and your viral load is undetectable on ART, the risk to your baby is already close to zero. This is from either vaginal or caesarean delivery. Please see the c-section info in the guide to HIV pregnancy and women’s health.

    So it is possible to have a natural and safe delivery without transmission to your baby.

    The recommendation for breastfeeding isdifferent for different countries. And HIV positive woman on treatment with an undetectable viral load can breastfeed. And also if viral load is detectable, but they are on treatment, yet don’t have access to formula, they can breastfeed.

    For more info please see the following for the World Health Organisation:
    http://apps.who.int/iris/bitstream/10665/246260/1/9789241549707-eng.pdf?ua=1

    If you live in South Africa you can contact the Treatment Action Campaign for local support.

  3. Thozama

    Hi my name is Thozama, I’m Hiv positive but and viral load has been undetactable for 3years, my baby was born in June 2017,i did not breastfeed at all, she’s 2years old now and and has tested negative. I’m currently pregnant with my second baby and I just wanted to know if it was safe to breastfeed since my viral load is undetectable? I want to breastfeed baby and I would also like to have a natural birth, since my 2year old was born via elective c-section. I want to know if it is possible to a natural and safe delivery and breastfeed without transmission to baby?

    Regards Thozama

  4. Roy Trevelion

    Hi Beth,

    It sounds as though you’re doing everything you can. Your HIV treatment (ART) aims to get your viral load down to undetectable by the time your baby is due.

    Please talk to your doctor and make sure your viral load is coming down from what it was when you started ART. You can also discuss the best way to have your baby with your doctor.

    In some countries HIV positive mothers breastfeed, without using formula at all, for just 6 months. And then they wean their baby onto soft food. Here in the UK it’s not recommended to breastfeed, and babies are fed using only formula.

  5. Beth

    Hi,am Beth,I found out I was hiv+ when I was 3 months pregnant and started medication immediately.After three months I did a viral load test which showed 130 copies/ ml but I have researched on internet and gotten to know that undetectable should be less than 100 copies / ml so am confused should I go ahead with my plan of giving birth normally or C-section and shouldn’t breastfeed my baby coz my viral load is above undetectable.pliz advise me what should I do.

  6. Ameswa

    Hi. I just want to ask if is it possible for me to breastfeed my baby when he is six months? My viral load is undetectable and I never breastfeeded my baby at birth. Can I start breastfeeding at 6 months and also give him some solid foods. Thank you

  7. Roy Trevelion

    Hi Charlotte,

    It’s great that you are taking HIV medication (ART) and have an undetectable viral load. ART can look after your health and it can look after your baby’s health too. So you are doing what you can to protect your baby from HIV.

    However, please see the Q&A where Angelina explains what is the safest way to feed your baby. So it’s important you discuss breastfeeding with your doctor.

    The World Health Organisation recommends 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.

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

    Please also talk to your doctor about Septrin. This is usually given to help treat or prevent other infections.

  8. Charlotte

    Am HIV positive mother on medication and my viral load was undetectable…. Can I breastfeed my baby for 15months or am risking my baby. Please note ; baby is given septrin on daily basis

  9. Lisa Thorley

    Hi Linda.

    If you’re undetectable then there’s no reason why you cannot have a vaginal delivery. Your HIV isn’t an issue.
    Guidelines around breastfeeding vary from country to country. In the UK breastfeeding isn’t recommended and this is even if a woman’s viral load is undetectable. However in the South Africa it is. This is something that you should talk to a healthcare professional about. The following may also help: http://i-base.info/guides/pregnancy

  10. Linda

    Hello i need your advise urgently.
    I’m hiv+ and 36 weeks pregnant. I found out about my status when i was 2-3 months preg then i started arv meds immediately. Now at the clinic they say I’m doing well my viral load is undetectable so I want to know does that means
    i will give birth virginal or with a c-sec.?
    Also want to know
    Which way is best to feed my baby formula or breastfeeding? Coz it has been always my wish to breastfeed my baby before i found out abt my status but now I’m scared to risk to transmit virus to a innocent soul and also don’t mind to formula feed her if is the best coz i can i afford it. Im really worried and want to know which way is best for her with no harm or even uncomfortable side effects to her. Plz help me I’m worried and confused as I’m gonna give birth anytime soon.
    I’m from South Africa. Thank you in advance

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