In February 2023, the US Centers for Disease Control updated their recommendations on infant feeding among mothers living with HIV, and no longer recommends advising against breastfeeding. They now recommend patient-centered, evidence-based counseling on infant feeding options, in line with some other high-income countries. They acknowledge that there is less than 1% risk of HIV transmission via breastfeeding for people living with HIV on anti-retroviral therapy with undetectable HIV viral loads. Although the CDC outlines management considerations, institutions are seeking standardized approaches to care for people living with HIV who want to breastfeed.
Authors at the Children’s Hospital of Colorado Immunodeficiency Program (CHIP) documented their experience developing and implementing an interdisciplinary approach to managing breastfeeding for people living with HIV and reported their patient outcomes. They reported on breastfeeding rates, and complications related to breastfeeding and infant antiretroviral treatment among 21 pregnant women who considered breastfeeding and 10 dyads who breastfed for a median of 62 days. They also discussed strategies to support pregnant individuals when making their infant feeding decisions, suggestions on prenatal lactation education topics, and interdisciplinary support for dyads. They discussed differing strategies for infant antiretroviral treatment from various institutions. Although there are no standardized approaches yet, there are some basic guidelines recommended by the CDC.
Valdenise Martins Laurindo Tuma Calil
How long do newborns or breastfed infants need to receive prophylaxis?
IABLE
I suggest reading the article. Institutions have provided prophylaxis for different durations of time.
Anne Pomerleau
how does exclusivingly breastfeeding leads to less transmission?
Also is it new guyidelines? Everytime the topics come up on dr milk the consensus seems to be ne breastingin in HIV mom in US/Canada I,M surprised!
IABLE
Here are the new CDC guidelines- https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html
This is a very recent recommendation, so past posts in Dr. Milk were based on previous CDC advice. Exclusive breastfeeding, as opposed to mixed feeding, is associated with less transmission of HIV (assuming antiretroviral therapy is optimized for parent and infant) because with mixed feeding, there may be more breast inflammation/mastitis, and the infant has a compromised gut lining from formula intake.