Call to drop mixed feeding

New Delhi, April 1: Breastfeeding guidelines for HIV-infected mothers may need to change with a study from South Africa showing that exclusive breastfeeding reduces the risk of HIV transmission from mother to child.

The study has shown that infants who received formula milk or animal milk along with breast milk had twice the risk of becoming infected with HIV compared with infants who received only breast milk.

The findings, published on Thursday in the research journal The Lancet, also show that infants who were given solids in addition to breast milk were 11 times more likely to acquire an HIV infection.

Exclusive breastfeeding for infants below six months has long been recognised as the ideal practice because breast milk protects the babies against myriad infections that can threaten their lives.

But since breast milk itself may carry the virus, some HIV-positive mothers have been opting for substitute feed such as special formulations for infants.

“We believe that the current guidelines on infant feeding warrant revision,” said Hoosen Coovadia from the University of KwaZulu-Natal in South Africa, whose study has highlighted the “protective shield” offered by breast milk even against HIV.

Coovadia and his colleagues have shown that the introduction of animal milk or solid food increases the risk of HIV transmission, and have demanded a revision of existing infant-feeding guidelines from Unicef, WHO and UNAIDS.

However, senior officials with the National AIDS Control Organisation (Naco) said India already has an “unwritten policy” of encouraging exclusive breastfeeding of infants below six months.

“We realise that there may be a small risk of HIV transmission, but without breast milk, infants may face the risk of other life-threatening infections,” a senior Naco official said.

“But we totally discourage mixed feeding. Mixed feeding may lead to tiny lesions in the oral tract or the food pipe that may allow the virus to infect the infant.”

Researchers believe that the mucous membrane that lines the intestines functions as a barrier to HIV infection. And breastfeeding itself is known to strengthen and protect the mucous membrane.

It is still not clear why exactly the infants who were given solid food along with breast milk had an 11-fold higher risk of HIV than infants who received only breast milk.

Previous studies, however, had shown that larger, complex proteins found in solid foods may lead to erosions in the lining of the stomach, which would allow the virus to pass through the wall of the gut.

The South African researchers also found that the death rate for babies who were given substitute feed was double that for babies fed exclusively with breast milk.