Breastfeeding by women with HIV infection

Potential parents living with HIV have the right to be fully informed regarding feeding options for babies born to mothers with HIV infection.

If you have HIV infection, the Ministry of Health recommends that you do not breastfeed your children. In developing countries, the nutritional and health benefits of breastfeeding outweigh the risk of transmitting HIV via breastfeeding. This is not the case in New Zealand, where there are safe and effective alternatives to breastfeeding.

Research from the developing world demonstrates that women living with HIV can reduce the risk of HIV transmission to an infant through breastfeeding by following a regimen of anti-retroviral therapy (ART) and exclusively breastfeeding1 for up to six months. However, in the absence of evidence demonstrating the complete elimination of HIV transmission, the Ministry of Health recommends that women with HIV do not breastfeed.

All parents with HIV should be offered adequate support to make decisions around infant feeding. Such support should be culturally appropriate and offered by trained support staff. Support should include education around and support for feeding options such as formula feeding and appropriately screened donor milk where available. These parents should receive ongoing monitoring and follow-up, as well as access to treatments and medications for parent and child as appropriate. Support should be individualised and available across all regions of NZ.

When a mother in New Zealand chooses to exclusively breastfeed, while taking ART and having a repeatedly undetectable viral load,2 the Ministry of Health would not regard this as grounds for automatic referral to child protection services.

Further information is available from:

Footnotes

1: Breastfeeding should be exclusive. Once the baby receives foods other than breast milk (such as formula or solids), the risk of HIV transmission from breastfeeding increases, and other feeding options should be used. 

2: Advice should be sought from experts in the area of HIV to provide best care in this situation.

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