Key Takeaways

The American Academy of Pediatrics now supports breastfeeding by HIV-positive moms, if their infection is controlled

The risk of HIV transmission through breastfeeding is less than 1% if the mom is virally suppressed

That risk should be weighed against the many benefits of breastfeeding, the AAP says

MONDAY, May 20, 2024 (HealthDay News) -- The nations top pediatrics group has reversed its decades-old position on HIV-positive mothers breastfeeding their infants.

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The American Academy of Pediatrics now says its generally safe for moms with HIV to breastfeed or provide breast milk to babies if their infection is properly controlled.

The risk of HIV transmission through breastfeeding from a mother who is virally suppressed is less than 1%, according to an AAP evidence review published May 20 in the AAP journal Pediatrics.

That small risk should be weighed against the health and financial benefits of breastfeeding, the AAP says.

Research now shows that the risk of HIV transmission through breastfeeding is quite low when the lactating parent is on anti-retroviral treatment and has no detectable viral load, said Dr. Lisa Abuogi, lead author of the AAP review.

While avoiding breastfeeding is the only option to guarantee that the virus is not transmitted, pediatricians should be ready to offer family-centered and nonjudgmentalsupport for people who desire to breastfeed, said Abuogi, who is medical director for the Children's Hospital Colorado Immunodeficiency HIV Prevention Program.

Nearly 5,000 people with HIV in the United States give birth every year, the AAP says.

Without treatment, women with HIV can pass the virus to their infants during pregnancy, delivery or breastfeeding.

However, daily medications can keep people with HIV healthy and reduce their viral load below detectable levels, the AAP noted.

The AAP says it is following the lead of the U.S. Centers for Disease Control and Prevention, which starting in 1985 had recommended against breastfeeding for people with HIV. The CDC now supports breastfeeding for HIV-positive mothers after discussing the option with a doctor.

The AAP recommends that pediatricians:

Know the HIV status of pregnant women, to provide appropriate counseling and prescribe antiretroviral treatment

Be prepared to support HIV-positive women who want to breastfeed if they started antiretroviral treatment early in or prior to pregnancy and are committed to maintainingviral suppression through breastfeeding

Counsel pregnant women and new mothers at increased risk of HIV infection regarding the risk of transmitting the virus through human milk, if infection occurred while breastfeeding

Healthcare professionals, researchers and people with HIV have made amazing strides over the past few decades towards eliminating perinatal transmission of HIV in the United States, Abuogi said in an AAP news release. "We encourage families to share information with their pediatricians about HIV and discuss what will work best for them when it comes to feeding their baby.

SOURCE: American Academy of Pediatrics, news release, May 20, 2024

Moms with HIV who want to breastfeed should talk with their doctor about whether it will be safe for their baby.

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In a Shift, Pediatricians' Group Says Breastfeeding Safe When HIV-Positive Mom Is Properly Treated - jacksonprogress-argus