Transmission Of Hiv From Mother To Child Through Breast Milk
Mother-to-child transmission of HIV is the primary way that children become infected with HIV. Such transmission can take place when the child is still in the mothers womb, around the time of birth, or through breastfeeding after birth. Hundreds of thousands of children are infected this way every year, with most of them in developing countries. Major progress has been made in preventing MTCT when the baby is still in the mothers womb, or around the time the baby is born. In many resource-rich settings, mothers with HIV infection are counseled not to breastfeed their children, and there are feasible and affordable alternatives to breastfeeding. However, in parts of the world where the vast majority of mothers with HIV infection live, complete avoidance of breastfeeding is often not feasible . Therefore, interventions to prevent transmission of HIV infection through breast milk are urgently needed. The authors found that, in addition to complete avoidance of breastfeeding if safe and affordable, exclusive breastfeeding for the first few months of life helps prevent transmission . Another intervention, giving the baby an anti-HIV medicine while breastfeeding, decreases the risk of transmission of HIV from mother to child. Implementation of such interventions, as well as developing more and better interventions, is essential.
Is It Safe To Take Hiv Medication In Pregnancy
Some medicines for HIV arent suitable to take during pregnancy.
If you have HIV and become pregnant, contact your local HIV clinic.
This is important because:
- some anti-HIV medicines can harm unborn babies, so your treatment plan will need to be reviewed
- additional medicines may be needed to prevent your baby getting HIV
But if youre taking HIV medication and you become pregnant, do not stop taking your medication without first speaking to your GP.
Always check with your GP or midwife before taking any medicine when youre pregnant.
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Getting Pregnant When Both Parents Have Hiv
Seroconcordant couples , can have an HIV-negative child. If both partners are on treatment, the risk of either partner transmitting HIV to their baby is almost zero.
If you are a seroconcordant couple and you are thinking of becoming pregnant it is important to speak with an obstetrician and an HIV specialist to minimise the risk of transmitting HIV to your baby.
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Body Fluids That Transmit Hiv
What body fluids transmit HIV?
Only certain body fluids from a person who has HIV can transmit HIV. These fluids include
- vaginal fluids, and
- breast milk.
These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.
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What If My Baby Is Hiv
With excellent health care, the mother-to-child HIV transmission rate is almost zero.
In the very rare case, your baby is HIV-positive, there are many supportive professionals and organisations that can help you during this difficult time.
You can expect welcoming, non-judgemental and compassionate care for yourself and your baby.
Medical care for babies with HIV is highly specialised. Early diagnosis means that a baby can begin effective treatment and have every chance for a long, healthy life.
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Risk Factors For Mother
Univariate logistic regression models were fitted among the 328 HIV-1positive women to examine the relationship between maternal factors and mother-to-child transmission of HIV-1 at 6 weeks and 12 months of age . Elevated breast milk sodium concentration, maternal plasma HIV-1 load, and breast milk lactoferrin level were associated with significantly elevated risk of mother-to-child transmission of HIV-1 by 6 weeks and 12 months of age. In a multivariate logistic regression analysis, maternal plasma HIV-1 load and elevated breast milk sodium were independently associated with significantly increased risk for mother-to-child transmission of HIV-1 to 6 weeks of age .
Univariate and multivariate models for mother-to-child transmission of human immunodeficiency virus to 12 months.
In the subsample of 134 women who had breast milk HIV-1 load measurements, multivariate logistic regression models were fitted to examine plasma and breast milk HIV-1 load as risk factors for mother-to-child transmission of HIV-1. Both plasma HIV-1 load and detectable breast milk HIV-1 load were independently associated with mother-to-child transmission of HIV-1 to 6 weeks of age. Both plasma HIV-1 load and detectable breast milk HIV-1 load were also associated with mother-to-child transmission of HIV-1 to 12 months of age.
Effective Treatments Can Reduce Hiv Transmission
When someone with HIV is on antiretroviral treatment and consistently has very low levels of virus they are not infectious and cannot sexually transmit the virus.
This may be true for sexual transmission during pregnancy, but researchers are still gathering more evidence before they can be confident it is true for transmission during pregnancy, labour and delivery, and during breastfeeding.
As long as the HIV-positive partner maintains a stable undetectable viral load and these medications are taken strictly as prescribed, HIV transmission to a negative partner is not possible.
Speak to your treating doctor if you would like to explore these newer prevention drugs.
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Protecting Your Baby During Childbirth
If you take your treatment correctly, it will lower the amount of HIV in your body. In some people, the amount of HIV in their body can be reduced to such low levels that it is said to be undetectable .
This means that you can plan to have a vaginal delivery because the risk of passing on HIV to your baby during childbirth will be extremely small.
If you dont have an undetectable viral load, you may be offered a caesarean section, as this carries a smaller risk of passing HIV to your baby than a vaginal delivery.
If your HIV test result comes back positive, there are a number of things you can do to reduce the risk of passing HIV to your baby.
I was diagnosed with HIV. After a few years I entered a relationship and we decided to have children. My HIV consultant assured me that it was fine since my viral load was undetectable. I had my twins through C-section, which was planned.
Exposure Of Humanized Blt Mice To Cell
Stocks of HIV-1JR-CSF, HIV-1RHPA, HIV-1CH040, and HIV-1CH077, were prepared and titrated as previously described . Oral inoculations of mice were performed by placing anesthetized BLT mice on their backs and instilling virus directly into their mouth. To ensure that all surfaces of the oral cavity were exposed to virus, initial oral exposure experiments were performed with 2.82×106 TCIU of HIV-1JR-CSF diluted in RPMI medium or normal human breast milk to a final volume of 50 µl. Once all surfaces of the oral cavity were exposed to virus, the excess virus was pipetted out of the oral cavity and the volume measured to determine the actual inoculum . Mice were held in place for 5 minutes to ensure retention of the virus. Once mice recovered from anesthesia, they were permitted immediate access to food and water. Subsequent oral exposures to HIV-1JR-CSF were performed using a total volume of 20 µl and 1.4×106 TCIU of virus. BLT mice exposed orally to HIV-1 T/F viruses were administered 6×105 TCIU of HIV-1RHPA, HIV-1CH040, HIV-1CH077 or HIV-1JR-CSF in 20 µl RPMI medium. To assess the efficacy of systemic FTC/TDF PrEP on oral transmission of cell free HIV in BLT mice, mice were administered FTC/TDF intraperitonealy once daily for seven consecutive days. Three hours after the third administration of FTC/TDF, BLT mice were exposed orally to 1.4×106 TCIU cell-free HIV-1JR-CSF.
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World Health Organization Guidelines On Hiv And Infant Feeding
The World Health Organization /United Nations Childrens Fund Guidelines on HIV and Infant Feeding were most recently updated in 2016. These guidelines are intended mainly for countries in Africa and Asia with high HIV prevalence and settings in which diarrhoea, pneumonia and undernutrition are common causes of infant and child deaths.
The 2016 recommendations state that mothers living with HIV should exclusively breastfeed their babies for six months, then introduce appropriate complementary foods and continue breastfeeding up to at least the childs first birthday. This is similar to the advice for women in the general population. During this time mothers should be fully supported to adhere to their HIV treatment by their healthcare team.
Although there is still some risk of passing HIV to their babies, mothers living with HIV are advised that breastfeeding provides a better chance of surviving than when using infant formula. Babies fed with formula milk in these countries have a greater risk of diarrhoea, pneumonia and malnutrition. Breastfeeding provides many short- and long-term health benefits to both mother and child and plays an important role in child development.
Reducing Hiv Transmission During Labour
Ways to reduce HIV transmission during birth include:
- Avoiding procedures in labour that may scratch or cut the babys skin, wherever possible .
- Giving antiretroviral medications to the newborn for around 4 weeks after birth.
Caesarean delivery is recommended if a woman:
- Has a detectable viral load, .
- Is not taking antiretroviral treatment.
- Experiences obstetric delivery complications .
- Has other medical illness complications.
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Taking Antiretroviral Treatment To Protect Your Baby
Taking treatment properly can reduce the risk of your baby being born with HIV to less than 1%.
If you knew that you were HIV-positive before you got pregnant, you may be taking treatment already. If you are not, talk to a healthcare professional about starting treatment as soon as possible.
If you found out that you living with HIV during your pregnancy, it is recommended that you start treatment as soon as possible and continue taking it every day for life.
Your baby will also be given treatment for four to six weeks after they are born to help prevent an HIV infection developing.
Risk Of Hiv Transmission From Breast
The risk of mother-to-child HIV transmission associated with breast-feeding may be especially high if the woman has only recently become infected, according to a prospective cohort study conducted in Zimbabwe.1 Among women who had been HIV-negative at delivery but became infected while breast-feeding, the transmission rate was 35 per 100 child-years of breast-feeding during the first nine months after infectionsubstantially higher than the rate among mothers who had been HIV-positive prior to delivery . The transmission rate eventually plummeted among newly infected women: None of their infants became infected 1224 months after their mothers had. Overall, 24% of mothers who had become infected while breast- feeding and 14% of those who had been infected at delivery transmitted the virus to their infants during the 24-month study.
Mean age at enrollment was 26 for women who were HIV-positive at delivery and 23 for those who seroconverted during the study. Both groups had an average of 10 years of schooling and a median monthly household income of about US$75. Almost all women were married or in union. The vast majority did not exclusively breast-feed their infant beyond the first three months.
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Hiv/aids In Pregnant Women And Infants
Human immunodeficiency virus is the virus that causes AIDS. When a person becomes infected with HIV, the virus attacks and weakens the immune system. As the immune system weakens, the person is at risk of getting life-threatening infections and cancers. When that happens, the illness is called AIDS.
HIV can be transmitted to the fetus or the newborn during pregnancy, during labor or delivery, or by breastfeeding.
This article is about HIV/AIDS in pregnant women and infants.
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How Is Hiv Transmitted From Mother To Child During Pregnancy
If you are a pregnant woman living with HIV there are a number of ways that HIV might be passed on to your baby. HIV in your blood could pass into your babys body. This is most likely to happen in the last few weeks of pregnancy, during labour, or delivery. Breastfeeding your baby can also transmit HIV, because HIV is in your breastmilk.
There is a 15 to 45% chance of passing HIV on to your baby if neither of you take HIV treatment.
However, taking the correct treatment during your pregnancy and while you breastfeed can virtually eliminate this risk.
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Can Hiv Be Transmitted Through Breastmilk
Many diseases and illnesses can be transmitted through the air, through sharing bodily fluids and through the water. One very big question is: Can HIV be transmitted through breast milk? Many new mothers who have been diagnosed with HIV would be keen on breastfeeding their babies. But is it safe to do so? Read more to find out the answer to Can HIV positive mothers breastfeed?
Thetruthful answer is that it is not. There is a very great risk that thebreastmilk from a mother infected with HIV would carry the disease as well.Babies who drink this milk may also become infected with the virus because theydrink the milk.
Although the overall risk for the virus to be transferred to the infant is only 16%, it would be impossible for doctors to predict how much of the virus would be in the breastmilk that the child consumes. The mother would also have no means of controlling the number of viral loads can be in her breastmilk at any given time. This unpredictability is what makes it unsafe for mothers with HIV to breastfeed.
Whatis antiretroviral treatment?
This is a treatment that would prevent HIV from being passed on to the next generation. If a mother had already been diagnosed with HIV before getting pregnant, they would most likely be having treatment already.
Whatis a good substitute for breastmilk?
Donot let HIV define you
Why Is The Advice Different According To Where You Live In The World
British, European and US medical guidelines state that formula milk is safer than breastfeeding if you are living with HIV. However, the World Health Organization states that this is not the case for mothers living in places where children are at high risk of diarrhoea, pneumonia and malnutrition. In many low-income countries, around one in twenty babies die before their first birthday, often due to these conditions. Breastfeeding provides essential protection against diarrhoea, pneumonia and malnutrition.
The risk of HIV transmission must be balanced against the risk of other serious illnesses.
Formula milk is a breast milk substitute that provides babies with the nutrients they need to grow and develop. However, it has three main disadvantages which are particularly relevant in some parts of the world.
Firstly, because formula is given to the baby using bottles, there is always a risk of bacteria that can cause diarrhoea and vomiting if you dont have access to clean drinking water and sterilisation.
Secondly, formula can’t strengthen your babys immune system in the way that breast milk can. In many poorer parts of the world, breastfeeding significantly reduces infant deaths by protecting against dangerous infections such as pneumonia.
Thirdly, there is a considerable expense associated with formula feeding, including the purchase of sterilising equipment and bottles. Many women on low incomes, whether in the UK or elsewhere, struggle to afford this.
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Hiv Transmission And Breastfeeding: What Do We Know
Breast milk is one of the body fluidsalong with blood, semen , vaginal or rectal fluidsthat transmit HIV. While the risk of transmission through breast milk drops if you are taking HIV drugs and your viral load is undetectable, there may still be some risk. Having an undetectable viral load in blood may not guarantee an undetectable viral load in breast milk. More research is needed into how HIV drugs affect the cells in breast milk, as well as breastfed infants.
A study among more than 2,000 women and their infants in Africa and India, called the PROMISE trial, compared results when either a breastfeeding mother or her infant took HIV drugs. In both parts of the study, HIV transmission rates to babies were found to be very lowless than 1 percent a year after birth. Two infants in this study did acquire HIV from their mothers, though there may be reason to believe the mothers did not have undetectable viral loads at the time of transmission.
In the US and other resource-rich countries, pregnant women are often told that “breast is best,” but women living with HIV are also told that they should not breastfeed. With modern HIV drugs, women’s viral loads may be below detectable levels for a long time. This has many women living with HIV wondering whether the advice not to breastfeed is still true for them.
Update On Hiv And Breastfeeding
Pamela Morrison, IBCLC, West Sussex, England
La Leche League Leaders occasionally receive requests for information about whether mothers who have tested positive for the Human Immunodeficiency Virus can breastfeed their babies.
Although the discovery that the virus can be passed from mothers to babies during breastfeeding was made in 1985, the original international advice from the World Health Organization was that breastfeeding should continue, since the risk of death from acquisition of the virus through mothers milk was less than the risk to babies when breastfeeding was withheld. It was not until 1997 that this recommendation changed to suggest that when formula feeding could be made acceptable, affordable, feasible, sustainable and safe, then there was less risk to babies when breastfeeding was withheld.
In spite of this guidance, it is often believed that a diagnosis of HIV precludes breastfeeding. It needs to be acknowledged that in the era of effective antiretroviral treatment, fears of transmission through breastfeeding are often exaggerated, while the risks of formula-feeding are down played.
In 2013 the American Academy of Pediatrics issued recommendations outlining that support should be given to HIV+ mothers who wanted to breastfeed. While formula-feeding is described as the initial option, later in the document, specific strategies for support and care of breastfeeding mothers and their babies are clearly outlined.
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