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 Winnie,
If you want to stop breastfeeding your daughter before she’s 6 months old you can. Its important however not to mix feed.
can I stop breastfeeding the baby and give her formula before 6months and are there no complication
Hi Betty,
Has your viral load ever been undetectable and how long were you on meds for before you gave birth?
Its not possible to say if your baby will be negative or not, this is why babies need to take meds when they are born and also be tested. Not breastfeeding though when you have a detectable viral load is good. For more info, please see here:
http://i-base.info/guides/pregnancy
yes I was on meds
Hi Betty,
When you gave birth were you on meds?
Can the baby be affected if the mother has a CD4 count of 559 and viral load of 355 and does formula?
Hi Lizzy,
ilvitrim suspension is a combination of two antibiotics, it isn’t an ARV. Therefore, you should ask your doctor why your baby has bee given it.
Testing negative already is a good sign. However, you may have to wait until your son is 18 months to find out for sure if he is negative or not.
Hi, my baby is 6weeks now they stop him from nervapine, he was negative when he test from birth.
So at 6weeks they did not test they said when he 10/weeks they will test. But they give him ilvitrim suspension, is it good for my baby because I don’t know what it for? Can you explain what is for? Or is that my baby positive?
Hi Steph,
The World Health Organisations recommendations are that if a woman is on treatment and their viral load is undetectable then they can breastfeed. For more info please see here:
http://apps.who.int/iris/bitstream/10665/246260/1/9789241549707-eng.pdf?ua=1
You can however choose to use formula. With formula there is no risk of transmission through feeding.
Hi,
My name is Steph, I’m positive and undetectable. I would love to breastfeed my baby,but all I here is that we should use formula. How will I be able to feed my baby without transmitting?