American Pediatricians Association Now Recommends Breastfeeding for HIV-Positive Mothers

The American Academy of Pediatrics recently made a significant policy change regarding breastfeeding for people with HIV. In a new report, the AAP stated that individuals with HIV can breastfeed their babies as long as they are taking medications that effectively suppress the virus that causes AIDS. This marks a sharp reversal of recommendations that have been in place since the 1980s at the start of the HIV epidemic.

Dr. Lisa Abuogi, a pediatric HIV expert at the University of Colorado and the lead author of the report, emphasized that the routinely prescribed antiretroviral therapy drugs can significantly reduce the risk of transmitting HIV through breast milk to less than 1%. While these medications are highly effective, they do not completely eliminate the risk of transmission. The only certain way to prevent spreading the virus is to avoid breastfeeding altogether.

It is crucial for parents with HIV who choose to breastfeed to breastfeed exclusively for the first six months of the baby’s life. Research has shown that switching between breast milk and formula can disrupt an infant’s gut in ways that increase the risk of HIV infection. Currently, about 5,000 people with HIV give birth in the U.S. each year, with nearly all of them taking medications to suppress the virus to very low levels.

Before the widespread availability of these medications, about 30% of HIV infections transmitted from mothers to babies occurred during breastfeeding. However, with the advancements in antiretroviral therapy, the number of infections has drastically decreased. Today, fewer than 30 infants in the U.S. acquire HIV each year.

The new AAP policy aligns with the recommendations from the National Institutes of Health and the Centers for Disease Control and Prevention, which advocate for counseling individuals with consistent viral suppression on their breastfeeding options. It emphasizes the importance of not alerting child protective services agencies if a parent with HIV seeks to breastfeed, focusing instead on supporting and empowering patients.

Breastfeeding provides ideal nutrition for babies and offers protection against various illnesses and conditions. It also has numerous benefits for the mother, including reducing the risk of breast and ovarian cancer, diabetes, and high blood pressure.

The World Health Organization has recommended since 2010 that women with HIV in developing countries breastfeed their infants while accessing antiretroviral therapy. In developed nations, experts had previously advised against breastfeeding due to the availability of safe alternatives to breast milk. However, the shift in recommendations acknowledges the importance of listening to patients and providing them with informed choices.

Ultimately, the new AAP guidance provides essential information for pediatricians, nurses, and lactation specialists working with children and families. It is essential to support individuals with HIV who choose to breastfeed, as it is a personal decision that can have significant benefits for both the baby and the mother.

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