Each time LaTonya looks at framed photos of herself breastfeeding her baby son for the first time, she swells with emotion. <\/p>\n
As a mother living with HIV in Colorado, it was a moment she wanted to commemorate. <\/p>\n
\u201cThat\u2019s how important it was to me to be able to breastfeed,\u201d LaTonya said about the photos. \u201cSo, I wanted to make sure we had that forever.\u201d <\/p>\n
For the first time, the American Academy of Pediatrics has changed its position to say people with HIV, the human immunodeficiency virus, can breastfeed their infants with \u201cvery low\u201d risk if they follow certain guidelines with support from their medical care team. <\/p>\n
Avoiding breastfeeding is the only option with zero risk for HIV transmission, but going forward, pediatricians should offer support and counseling for women who wish to breastfeed, who are receiving antiretroviral treatment, known as ART, as prescribed and who are maintaining an undetectable amount of virus in the body, according to a new clinical report from AAP that was published Monday in the journal Pediatrics. <\/p>\n
Previously, the academy recommended that mothers with HIV in the United States not breastfeed their infants, regardless of their viral load and antiretroviral therapy use. <\/p>\n
Recommendations against breastfeeding for people with HIV date to about 1985, when the US Centers for Disease Control and Prevention recommended that women with HIV infection avoid breastfeeding. <\/p>\n
\u201cThe AAP recommends that for people with HIV in the United States, replacement feeding (with formula or certified, banked donor human milk) is the only option that is 100% certain to prevent postnatal transmission of HIV,\u201d the new <\/strong>report says. \u201cHowever, pediatric health care professionals should be prepared to provide infant feeding counseling and a family-centered, culturally sensitive, harm reduction approach for people with HIV on ART with sustained viral suppression who desire to breastfeed.\u201d <\/p>\n HIV is a virus that attacks the body\u2019s immune system, and if not treated, it can lead to acquired immunodeficiency syndrome or AIDS. <\/p>\n LaTonya has been living with HIV for about 20 years, she said, but as soon as she gave birth to her son, she knew that she wanted to breastfeed because of the health benefits breastfeeding has for infants, including being associated with a lower risk of asthma, obesity, type 1 diabetes and sudden infant death syndrome. <\/p>\n \u201cBeing a mom is absolutely amazing. I wouldn\u2019t trade it for the world,\u201d LaTonya said, adding that every parent desires to give their child \u201cthe best shot\u201d at being the best person that they can be. <\/p>\n \u201cI feel like breastfeeding was a step towards me being able to provide that for him,\u201d she said of her son. <\/p>\n After she talked talking about her decision with her doctors, they developed a plan for her to breastfeed since her viral load is undetectable and she is taking antiretroviral medications. <\/p>\n \u201cI think it\u2019s essential for people to understand the science behind it,\u201d she said. \u201cIf you\u2019re undetectable, you cannot transmit it to your partner. It\u2019s essential for people to understand that, as well as, if you\u2019re adhering to your medication, that it\u2019s not going to transfer through the breast milk to your child. And so therefore, why deprive your child of \u2026 having that benefit?\u201d <\/p>\n Although HIV can be passed to infants through breastfeeding, research has shown that the use of antiretroviral drugs <\/strong>can significantly reduce the risk of HIV transmission, and these medicines are found to be safe during breastfeeding. <\/p>\n In the absence of the mother taking ART or the infant taking preventive antiretrovirals, the risk of HIV transmission through breast milk appears to be highest in the baby\u2019s first four to six weeks of life, ranging between 5% and 6%, according to the AAP report. <\/p>\n But the risk is \u201cestimated to be less than 1%\u201d if the mother is taking antiretroviral medications and the virus is suppressed in her body, meaning there is no detectable viral load, the report said. <\/p>\n \u201cWhat\u2019s new is that the AAP for the first time is explicitly saying that pregnant people with HIV who are on treatment and undetectable can be supported to breastfeed,\u201d said Dr. Lisa Abuogi, lead author of the report and a pediatrician in Colorado who works with people with HIV during their pregnancies. <\/p>\n \u201cThis has been a long evolution, and people living with HIV have been a part of advocating for this change,\u201d Abuogi said. \u201cSome women feel shame or distress or feel like they\u2019re not fulfilling their role as a mother if they can\u2019t breastfeed, and some are really worried that that discloses their HIV status in their community \u2014 if breastfeeding is the norm and you have to explain why you\u2019re not doing it.\u201d <\/p>\n It\u2019s estimated that about 5,000 people with HIV give birth in the United States each year. <\/p>\n \u201cSo having the opportunity to offer women the choice, as all women have, and to support their decision is really empowering,\u201d Abuogi said. \u201cPeople living with HIV should have all of the same infant-feeding options as anyone else, and we\u2019re really working to make that a safe decision for women.\u201d <\/p>\n Last year, an advisory panel to the US Department of Health and Human Services made similar updates to its recommendations around infant-feeding, saying that \u201cindividuals with HIV who are on ART with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision.\u201d <\/p>\n The new AAP position now aligns with those updated recommendations from the HHS panel, said Dr. Rana\u00a0Chakraborty,\u00a0a pediatric infectious disease specialist and researcher\u00a0at\u00a0Mayo Clinic\u00a0in Minnesota, who is a\u00a0member of HHS\u2019 Panel on Treatment of\u00a0HIV During Pregnancy and Prevention of Perinatal Transmission. <\/p>\n \u201cThis is something that\u2019s been under discussion for a few years now. It began with the Department of Health and Human Services panel, and I think the authors of this report from the AAP have really summarized very nicely the current\u00a0national guidelines\u00a0in the US,\u201d said Chakraborty, who was not involved in the new AAP report. <\/p>\n \u201cA number of investigators, including many from the US working in relatively resource-limited settings, were\u00a0previously\u00a0able to demonstrate that\u00a0breastfeeding\u00a0could be\u00a0undertaken\u00a0safely if the mother is taking antiretroviral therapy and maintains undetectable HIV viral loads \u2014 in other words, the amount of virus in one drop of blood needs to be less than 50 copies per milliliter,\u201d he said. \u201cIn the US, this is\u00a0also doable. But\u00a0breastfeeding during\u00a0maternal HIV infection\u00a0does need a\u00a0supporting\u00a0multidisciplinary team of providers to make sure that this can be done safely for\u00a0both\u00a0mom and baby.\u201d <\/p>\n The AAP recommendations signal that there is now a consensus among leading medical groups that mothers living with HIV can be supported and counseled in safely breastfeeding their babies, said Dr. Elaine Abrams, professor of epidemiology and pediatrics at the Columbia University Medical Center in New York, who has treated people living with HIV during their pregnancies and postpartum but was not involved in the new AAP report. <\/p>\n \u201cAll of the bodies that provide guidelines to clinicians are now saying the same thing. We\u2019re seeing a consensus, and the consensus also puts the mother right up-front central in the conversation and decision-making,\u201d she said. <\/p>\n \u201cIt\u2019s moved away from telling her what to do, to rather understanding what she wants to do, providing her with evidence and information and then supporting her in her decision,\u201d Abrams added. \u201cIn the old days, that wasn\u2019t necessarily the case.\u201d <\/p>\n In the early 2000s, studies emerged showing that infants born to women with HIV in low-income countries had increased risks of illness and death when they were given formula \u2014 and that was found to be associated with the mothers not having safe drinking water to mix with the formula, according to the new AAP report. That prompted the World Health Organization to recommend that people with HIV should breastfeed their babies in places without safe drinking water and accessible formula. <\/p>\n As more mothers with HIV breastfed, more studies then found <\/strong>that when the mother took ART or the infant was given antiretrovirals preventively, that effectively reduced the risk of HIV transmission. <\/p>\n The new AAP report noted that there is no consensus on the optimal regimen of preventive antiretrovirals for infants during breastfeeding. Also, people who breastfeed are recommended to do so exclusively, because mixing breastfeeding and formula or solid foods\u00a0has been associated with increased HIV transmission. <\/p>\n \u201cThis increased rate may be a result of disrupted infant gut integrity associated with consuming substances other than human milk, decreases in the amount of antiviral or anti-inflammatory substances typically consumed in human milk, or other mechanisms,\u201d according to the AAP report. <\/p>\n LaTonya said that among the guidance that her medical team discussed with her for breastfeeding was to not incorporate formula but to breastfeed exclusively. <\/p>\n \u201cOne of the guidelines that we went over is, if we were going to breastfeed, that was the only thing that we could do,\u201d LaTonya said. \u201cWe could not mix formula and breastfeeding.\u201d<\/strong> <\/p>\n Along with supporting and counseling patients with HIV who wish to breastfeed, the AAP also recommended in the new report that pregnant people be routinely tested for HIV and those living with HIV or newly diagnosed should be linked to treatment. <\/p>\n LaTonya said that she hopes the new AAP recommendations encourage health-care providers to educate the public more about what an undetectable level of HIV means, how infections can be treated and how the virus can be suppressed. <\/p>\n \u201cIt\u2019s something people live with, and it\u2019s not something to be afraid of,\u201d LaTonya said. <\/p>\n The time for doctors to have those types of educational discussions with their patients would be when someone has a routine HIV test, she said. <\/p>\n \u201cThey will talk to you about gonorrhea and chlamydia, but the HIV portion is missing. And so therefore, a lot of people are still stuck in the \u201880s with their mentality of HIV and AIDS,\u201d LaTonya said. \u201cI believe that is mostly due to lack of education.\u201d <\/p>\n<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Each time LaTonya looks at framed photos of herself breastfeeding her baby son for the…<\/p>\n","protected":false},"author":1,"featured_media":2046,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[20],"tags":[],"_links":{"self":[{"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/posts\/2045"}],"collection":[{"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/comments?post=2045"}],"version-history":[{"count":0,"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/posts\/2045\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/media\/2046"}],"wp:attachment":[{"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/media?parent=2045"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/categories?post=2045"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthyretirementnews.com\/index.php\/wp-json\/wp\/v2\/tags?post=2045"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} \u2018This has been a long evolution\u2019<\/h2>\n
\u2018We\u2019re seeing a consensus\u2019<\/h2>\n
<\/ul>\n<\/div>\n