Hesperian Health Guides
Chapter 9: Breastfeeding and HIV
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Breastfeeding is the most natural and healthy way to feed all babies — even if the mother has HIV. Taking ART during breastfeeding lessens the chance of HIV infection from breast milk, so much that it is rare for a baby to get infected by breastfeeding. So if you, your baby, or both of you take antiretrovirals during breastfeeding, your baby will have all the benefits of breastfeeding with little risk of HIV infection, especially if you started taking ART before or early in your pregnancy.
HIV can spread to some babies from breast milk, but this mostly happens when a breastfeeding mother is very ill from HIV, or if the mother is first infected with HIV during the months she is breastfeeding. Both of those times are when the amount of HIV in her body (her viral load) is highest. But if she is on ART, and her HIV is well controlled, breastfeeding is unlikely to spread HIV.
Breastfeeding will help a baby with HIV grow and stay healthy. Breastfeeding is recommended for at least 6 months and up to 2 years or beyond.
Why breastfeeding is good for a baby who might have HIV
- Breast milk protects babies against diarrhea, pneumonia, and other infections that are especially common and dangerous for babies with HIV.
- Breastfeeding makes it easier to feed a baby enough food to grow and develop well. Babies with HIV need even more food than those without HIV.
Even if you can only breastfeed for a while, until you return to work or school, for example, it is helpful for your baby. And if you have HIV but do not have access to ART, it is still usually safer for your baby to breastfeed for the first 6 months. For how to do this most safely, see Safer breastfeeding if you have HIV.