Question
What is the safest way to feed my baby?
4 January 2016. Related: All topics, Children, HIV transmission, Pregnancy.
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.
Hi Meries,
No one can force you to breastfeed your baby. If you would rather use formula then use formula. If the people from the clinic pass judgement, simple tell them that its nothing to do with them. Your baby is your baby and not theirs.
I’m meries
Why are we forced to breastfeed in South Africa? I don’t have a say in what’s best for my child especially if I go to a public hospital for my baby check up. Why is that because they are violating my right to make a choice for my baby.
Hi Thulisa,
In the UK its recommended to start weaning in babies once they turn 6 months. However, all babies are different. Please talk to your babies health care worker about baby feeding.
Hi i’m 6 months pregnant and hiv positive. I was told to breastfeed my baby after delivering for 6 months. What i want to know can i feed the baby some baby cereal before that 6 months is over.
Hi Veronica,
If the women who breastfeed your son is on treatment and has an undetectable viral load then her breastfeeding your son should be OK. This is because the World Health Organisation recommendations are that if a women is on treatment and has an undetectable viral load that they can breastfeed. Please see more info here:
http://apps.who.int/iris/bitstream/10665/246260/1/9789241549707-eng.pdf?ua=1
Because your friend has breastfeed your son, does this mean that she also has a child? If she does, what is the status of the child?
If your friend isn’t on treatment, then yes, the risk is much greater. However, your son has been given treatment, and it is very effective.
Could you please let me know if your friend is on treatment.
I have a problem, my neighbor just breastfeed my 3 months son and my neighbor is HIV positive, will my son be OK? We went to clinic and also the hospital, they took tests, I’m just waiting for results and he was given nevirapine. Will he be OK?
Hi Zimkhitha,
Congratulations on your pregnancy. How is it going?
The World Health Organisations recommendations are, that if you’re on treatment then you can breastfeed your baby. Please see here for more info:
http://apps.who.int/iris/bitstream/10665/246260/1/9789241549707-eng.pdf?ua=1
With regards to giving your baby umuthi wenyoni, you would only need to do this if they needed it. I would however discuss this with their doctor first.
Its not common to give babies water when they are first born. This is because they get all that they need from milk. Water is usually introduced when weaning a baby. It isn’t though a substitute for milk.
Hi, I’m 7 months pregnant. I’ve been on ARVs since I was 1 month pregnant. I’ve chosen to breastfeed my son. Now my question is, will I be able to give him some of other medication like umuthi wenyoni and all that and water?
Hi Lihle,
If you’re on treatment and undetectable then the World Health Organisation guidelines are that you can breastfeed your baby. If however, you prefer to bottle feed, you can also do this. You must not however, mix feed. Insofar as you either bottle feed 100%, or breastfeed 100%. It can happen that one nurse will say one thing, and another something else. The decision though it up to you. What’s important is being on treatment and being undetectable.
With regards to your sons status, he will need to be tested as recommended. Only then will you know for sure. However, the risks are very low because you’re undetectable and he’s been taking Nevirapin.
Hi my viral load was undetectable and I gave birth to a healthy baby boy. But now I’m worried. The doctor at the hospital recommended that I breastfeed my son, but when I took him for 3 days the nurse said I wasn’t supposed to breastfeed. I’m now confused. Should I be breastfeeding or giving him formula?He’s one month old. He’s on Nevirapin and I’ve never missed giving to him a dose and have always given him the dose at the same time. Could he have HIV?