HIV-Infected Mothers Who Decide to Breastfeed Their Infants Under Close Supervision in Belgium: About Two Cases

Abstract

Introduction: In most industrialized countries, human immunodeficiency virus (HIV) infection remains a formal contraindication to breastfeeding. However, for the past 9 years, the World Health Organization (WHO) has recommended, for developing countries, that mothers infected with HIV and treated by combined antiretroviral therapy (cART) should breastfeed their infants. HIV-infected women coming from developing countries and living in industrialized settings are increasingly expressing their natural desire to breastfeed. To avoid uncontrolled breastfeeding practices and reduce the risk of mother-to-child transmission of the virus, there is an urgent need to consider the wishes of these women. Discussion: We report two cases in which specific guidelines were implemented in order to support the mothers' choice to breastfeed in Belgium. As a result of different prophylactic measures including antiretrovirals in mothers and infants and close follow-up, none of the infants were infected. Conclusions: National or international recommendations for HIV-infected mothers who choose to breastfeed in industrialized countries remain unclear and discordant. There is an unmet need for experts to address this emerging issue and to develop an international consensus for the monitoring and prophylactic management of exposed-infants.

Brief Report: HIV-Positive and Breastfeeding in High-Income Settings: 5-Year Experience From a Perinatal Center in Germany

“…13,14,17,23 Although breastfeeding poses the possible risk of VT, it concurrently offers maternal health benefits, including superior uterus involution, reduced risk of depression, obesity, cancer, or diabetes. 7,13,18,24…”

“…Albeit, these guidelines acknowledge VT risk through breastfeeding is uncertain in situations with undetectable mVL. 7,9–13 Until now, no VT has been observed in WLWH who are in an optimal scenario, 14 consisting of regular clinical care, adherence to cART, and suppressed mVL throughout childbearing and postpartum period. 13–16…”

Assessment of Exclusive Breast-Feeding Practice among HIV-Positive Mothers in Abuja Nigeria

“…Globally, over 90% of HIV infections among children are due to mother-to-child transmission and breastfeeding accounts for 5-20% of the burden [7]. Accordingly, human immunodeficiency virus infection remains a formal contraindication to breastfeeding [9]. The best way to prevent transmission of HIV to an infant through breast milk is to not breastfeed [10].…”

Replacement feeding and the HIV Diaspora: A case of ontological multiplicity and fluid technologies

“…It is important to acknowledge that women living with HIV in sub‐Saharan Africa, the most affected region in the world (WHO, 2021) are advised to exclusively breastfeed for six months after birth and to continue to offer breastmilk till the child is at least two years old (WHO, 2021), notwithstanding a transmission risk ranging from 13 to 48% (Bansaccal et al, 2020; Coovadia, et al, 2007; Nduati et al, 2000, Nguefack, et al, 2016). Babies in these regions are more likely to die from a water‐borne illness before they have a chance to die from an HIV related illness (Overgaard et al, 2021; WHO, 2018, 2021).…”