Whatever you choose to do, do not blame yourself if your baby becomes infected with HIV. At the moment, there is no way to know for sure how to protect your baby.
Some mothers with HIV pass the infection to their babies through breast milk. Other mothers with HIV breastfeed their babies, and their babies do not become infected. No one knows exactly why HIV is passed to some babies and not others. HIV probably passes more easily during breastfeeding when:
the mother recently became infected with HIV.
the mother is very sick with AIDS.
the mother gives formula or other fluids along with breast milk.
the mother has cracked nipples or a breast infection.
the baby has thrush in her mouth.
For most mothers, even mothers with HIV, breastfeeding is the safest way to feed their babies. In places where water is not always safe, many babies get sick and die from diarrhea. And when people cannot always afford enough formula, babies die from malnutrition.
Breastfeeding if you have HIV
A woman who is being treated with medicines for HIV is less likely to pass the virus to her baby while breastfeeding. But even if you are not taking ART medicines, you can make breastfeeding safer:
Give only breast milk for the first 6 months. Babies who also get formula, teas, or other foods or drinks are more likely to become infected than babies who drink only breast milk. Other foods or liquids are harder for a small baby to digest and may irritate the lining of the baby ́s stomach. This may help HIV to pass more easily.
Stop breastfeeding after 6 months, but do not stop suddenly. It usually takes several days to wean a baby. (See Feeding an older baby.)
Position the baby correctly to avoid cracked nipples.
Treat thrush, cracked nipples, and breast infections right away.
Do not feed the baby from a breast that has mastitis or an abscess—instead, remove the milk and throw it away. Feed the baby with milk from the other breast, until the infection heals.
To kill HIV in breast milk, you can also heat the breast milk almost to boiling (pasteurize), and then cool it and feed it to the baby through a cup or a bottle. This takes work, but it can be done if you have clean water, fuel, and support.
To pasteurize breast milk
Place a jar of breast milk in a pot of water.
Bring the water to a boil.
Immediately remove the pot from the heat.
Let the milk cool before feeding it to the baby.
The milk should be used within a few hours of pasteurizing. Breast milk should not be boiled.