A group of top U.S. pediatricians on Monday made a major change in policy, saying people with HIV can breastfeed their babies as long as they take drugs that effectively suppress the virus that causes AIDS. Announced.
of new report The American Academy of Pediatrics’ recommendations reverse recommendations that have been in place since the beginning of the HIV epidemic in the 1980s.
Dr. Lisa Abuogi, a pediatric HIV expert at the University of Colorado and lead author of the report, acknowledged that regularly prescribed medications can reduce the risk of transmitting HIV through breast milk to less than 1%. Stated.
“We are now at a point where it is important to engage in shared decision-making because the efficacy of medicines is so great and the benefits for mothers and babies are so important,” Abuogi said. Stated.
This medicine, known as antiretroviral therapy, does not eliminate all risk of transmitting HIV through breast milk. Abuogi said avoiding breastfeeding is the only sure way to prevent the spread of the virus.
Additionally, parents should exclusively breastfeed their infants for the first six months, as studies have shown that switching between breast milk and formula can confuse infants’ intestines and increase the risk of HIV infection. It doesn’t have to be.
Approximately 5,000 people with HIV are born in the United States each year. Abuogi said almost everyone is taking medication that keeps the virus at very low levels, but if they don’t continue taking the medication, virus levels can rebound.
Before the drug became widely available a decade ago, about 30% of HIV infections passed from mothers to infants occurred during breastfeeding, said Dr. Lynn Moffenson, a consultant at the Elizabeth Glaser Pediatric AIDS Foundation. It is said that In the early 1990s, about 2,000 infections occurred in U.S. infants each year. Today there are less than 30 people.
The AAP policy comes more than a year after the National Institutes of Health and Centers for Disease Control and Prevention. overturn long-standing recommendations Opposes breastfeeding by people with HIV. The guidance says people who have consistently suppressed the virus should be advised about their options. They also stress that health care providers should not alert child protective services if a parent with HIV attempts to breastfeed.
Dr. Lin Yi, a professor of obstetrics and gynecology at Northwestern University who helped draft the NIH guidance, said the goal is to listen to patients and “not to blame or shame them.” he said.
Research shows that breastfeeding provides ideal nutrition for babies and protects them from diseases and conditions such as obesity and type 2 diabetes. Breastfeeding also reduces a mother’s risk of breast cancer, ovarian cancer, diabetes, and high blood pressure.
The World Health Organization recommends that Since 2010 Access to HIV-infected women in developing countries to breastfeed their infants and receive antiretroviral therapy. The guidance weighed the risk of infants acquiring HIV through breastfeeding against the risk of infants dying from malnutrition, diarrhea, and pneumonia in places where safe breast milk substitutes are not available.
However, in developed countries, experts recommend against breastfeeding because the risk of HIV infection can be eliminated if safe water, baby formula and human donor milk are widely available, Yi said.
This frustrated HIV-infected people who were flatly denied the option of nursing.
Ci Ci Cobin, 36, of Philadelphia, said she was diagnosed with HIV at age 20 and is not allowed to breastfeed her first child, Zion, now 13.
“I couldn’t understand how my younger sister, who lives in a place like Kenya and has the same dark skin and looks just like me, was given the option to breastfeed, and my choice was a flat-out no.” she said.
Unable to breastfeed her son, Cobin said she spiraled into postpartum depression. When she became pregnant with her now two-year-old daughter Zuri, her medical team helped her be able to breastfeed for her seven months. Cobin followed her instructions and took the prescription, giving the baby medication to prevent the infection.
“Breast milk contains everything a baby needs,” Cobbin said. “That’s a beautiful thing.”
Abuogi said the AAP report provides important guidance for pediatricians, nurses and lactation specialists who work directly with children and families.
Some health care providers were assisting people already receiving treatment for HIV to breastfeed their infants, despite previous recommendations. Abuogi said the new guidance should lead to expanded practice, hopefully quickly.
“This is a unique situation because it’s not just doctors and providers that are changing,” Abuogui said. “Our patients are driving this as well.”
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