BreastsBreastfeeding

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Recent research has found that if the mother is on HIV antiretroviral treatment and has an undetectable viral load, the risk of HIV transmission through breastmilk is low. That means in developing countries without a safe water supply, the World Health Organization recommends that HIV-positive women breastfeed if they can access antiretroviral treatments.

Women with HIV in Australia are still strongly advised against breastfeeding because HIV is present in breastmilk and our clean water supply allows for bottle feeding. Research has shown that levels of the virus in breast milk fluctuate unpredictably, even varying from left breast to right breast. The speculated cause is that small infections or inflammations of the breast tissue and milk ducts are very common and these increase HIV replication and shedding. Also, some HIV treatments have a small amount of ingredients that may also pass into your breastmilk.

You do not have to disclose that you are HIV positive to justify not breastfeeding. Many women do not (or cannot) breastfeed, for a whole range of reasons. However not breastfeeding can cause some women considerable stress within their family and/or community. If you feel a sense of distress, grief or loss about not breastfeeding your baby, talking to a counsellor or to other positive women may help. If you are looking for a way to explain your actions and don’t want to disclose your HIV status to those who question your choices, you could consider offering the following explanations:

  • My baby didn’t latch well.
  • I decided to bottle feed because it allows other people to take part in feeding and bonding with my baby.
  • My doctor advised me to formula feed because the baby wasn’t gaining weight.
  • I wasn’t making enough milk for my baby’s needs.
  • I decided not to breastfeed.
  • I prefer bottle feeding.
  • My baby doesn’t breastfeed well.
  • I needed to take a medication after delivery that made it not safe for my baby to breastfeed.

This list is drawn from the Canadian CATIE website.

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