The reported observation of mother-to-child transmission of HIV-1 through breastfeeding has resulted in policies recommending that some HIV-1-infected women avoid breastfeeding. There is debate about this among policymakers, however, because breastfeeding protects against infectious diseases -- particularly pneumonia and diarrhea -- that kill over nine million children worldwide each year. Now, an international team of scientists that includes scientists from the Johns Hopkins School of Public Health -- coordinated by the World Health Organization's Department of Child and Adolescent Health and Development and the Federal University of Pelotas, Brazil -- has found that breastfed infants were six times less likely to die due to infectious diseases in the first few months compared to those who were not breastfed. The results of the study are reported in the February 5 issue of The Lancet.
Using data from Brazil, The Gambia, Ghana, Pakistan, Philippines, and Senegal, the researchers found that breastfed children had a lower mortality rate through the second year of life; this protection diminished, however, as the children grew older. The study also found that the infants of women with lower levels of education -- that is, the women least likely to be able to afford safe breastmilk substitutes and so most likely to breastfeed -- had lower rates of infectious disease mortality.
Policy concerning HIV and breastfeeding is in review in many countries, and earlier studies (Lancet 1999 Aug 7:471-6) suggest that exclusive breastfeeding may reduce mother-to-child transmission of HIV-1 to a level close to non-breastfeeding. The current study should contribute to the debate on the association between breastfeeding and HIV transmission.
Experts on breastfeeding include:
Jose Martines (WHO's Department of Child and Adolescent Health and Development)
Robert Black, MD, MPH (professor and chair, International Health, Johns Hopkins School of Public Health)
Felicity Savage (WHO's Department of Child and Adolescent Health and Development)