Breast-feeding and maternal mortality. Several years ago, a small-scale clinical trial in Kenya raised concerns that the simple act of breast-feeding her baby could increase an HIV-infected woman’s risk of dying within two years of giving birth. Since this finding proved counter to those from other studies, NICHD-supported scientists analyzed data from clinical trials involving more than 4,000 HIV-infected women to resolve the concern. The researchers found no evidence of an increased risk of death in HIV-infected mothers who breast-fed their infants. In addition to laying to rest concerns about premature death, the study found that women who breast-fed for longer time periods actually lowered their risk of dying. These results and other important factors should reassure HIV-infected women that they can safely breast-feed their infants without increasing risk to their own health.

HIV transmission through breast milk. Although breast-feeding may be safe for HIV-infected mothers, it is a major source of transmission from HIV-infected mothers to their babies. In fact, without antiretroviral treatment, 40 percent of all HIV transmissions from mothers to their breast-fed infants may occur through breast milk. [i]   Two studies, however, now show that treating HIV-infected lactating mothers with highly active antiretroviral therapy (HAART) helps to prevent the transfer of the virus to their children. One study found that the three drugs that comprise HAART therapy passed into the mothers’ breast milk in significant concentrations, and one of these drugs made its way into the infants’ blood at high enough levels to be protective. In the other study, researchers found that HAART effectively reduced the level of one form of the virus in breast milk. Together, these studies underscore how HAART can help to prevent HIV transmission through breast milk, providing hope for HIV-infected mothers that breast-feeding does not have to lead to infecting their babies. This is especially important in developing countries where HIV infection rates are high and formula feeding can be problematic because of expense, lack of clean water, and social acceptance.

Growing up with HIV. Children with HIV are often shorter and weigh less than their uninfected peers. Researchers studying HIV-infected children, as part of the Pediatric AIDS Clinical Trials Group, found that HAART treatment helped these children attain a normal rate of growth (height and weight) compared with uninfected cohorts. This research shows that HAART does more than slow disease progression in HIV-infected children—the therapy also helps to ensure the steady growth and development of these children. The World Health Organization reported in 2004 that approximately 640,000 children were newly diagnosed with HIV worldwide. [ii]   HAART can help these children to develop and lead healthier, more productive lives.