Breast milk

Two-month-old Banele Dlamini awakes from a deep slumber and sucks hungrily at a bottle of formula proffered by his HIV-positive mother. Humming as she boils water in a kettle for his next feed, Zelda Dlamini says she is grateful to health workers in Soweto for telling her to avoid breast-feeding to ensure she does not pass the virus to the infant.

[LOS ANGELES] The benefits of breastfeeding outweigh the risks of virus transmission from HIV-positive mothers to their children, according to studies conducted in four African nations.

Avoiding transmission of HIV from mother to child after birth has become one of the greatest challenges in HIV prevention. Approaches to date to reduce or prevent postnatal transmission through breastfeeding have included the avoidance of all breastfeeding through the use of exclusive replacement feeds, or exclusive breastfeeding for a limited duration with early and rapid cessation of breastfeeding as soon as it is feasible.

Although experts say that breastfeeding gives children the best start in life, protecting them from life-threatening diseases and providing essential nutrients, barely a third of all infants in developing countries are exclusively breastfed for the first six months.

TORONTO - A South African study has conclusively shown that babies with HIV positive mothers who are exclusively breastfed are significantly less likely to get the virus than if they get breastmilk and other food mixed.

DURBAN, South Africa, Jan 27 (Reuters) - Six-month-old Matthew Coetzer bounces on his mother's knee. The bubbly blond and blue-eyed child is ready for his next meal of breast milk. But Matthew's mother is not just feeding her own son. In the family refrigerator are bottles of frozen milk, donations for a bank designed to bring the benefits of mothers' milk to orphans and sick children caught up in South Africa's devastating HIV/AIDS epidemic.

International food and beverage company Nestl is to provide a full report to the South African government on how it is addressing the erratic supply of infant formula to public health facilities.

A large study of mothers and children carried out in Zimbabwe lends further support to the view that it is probably better for mothers with HIV infection to breastfeed exclusively rather than engage in mixed feeding, as children exposed to a mixture of breastfeeding and other forms of feeding are more than four times as likely to have become infected with HIV at the age of six months when compared to infants exclusively breastfed.

For many HIV-positive mothers in resource-poor settings, breastfeeding is often the only option, despite the risk of HIV transmission. The challenge now is for healthcare workers to accept this reality and make breastfeeding safer, a recent report has said.

Orphaned babies, many of whom are HIV-positive, are getting more than basic love and shelter at a home in South Africa's port city of Durban. They are also receiving the gift of immune-boosting breast milk donated by a network of mothers in the city. The mothers voluntarily express the milk their own babies do not need, and it is then collected and taken to iThembaLethu, meaning I have a destiny in isiZulu, a transitional home for babies who have been orphaned or abandoned through HIV/AIDS. Not all have the HI virus, but most are very neglected and malnourished when they arrive. Coordinator Shirley Royal told PlusNews on Tuesday that the home, which cares for six babies at a time, combines a family environment, stimulation and good nutrition to help them recover while plans are made for them to be reunited with their family, or placed with another family. Aware of research demonstrating that breast milk boosts a baby's immune levels, the founder of the breast milk bank, paediatrics professor Dr Anna Coutsoudis, asked four friends, one of whom was Royal, to donate excess breast milk for an ailing baby that the home had just taken in. They were given an industrial pasteuriser, which enabled them to eliminate the HI virus and other viruses like hepatitis and syphilis, as well as donations of breast pumps and small plastic containers for the milk. Royal says that while pasteurisation - a heat treatment - removes many of the good qualities of breast milk, the milk is still beneficial and better than no breast milk. With funding from the UN Children's Fund to cover some costs, the home relies on good will and word of mouth, said Royal. Donors to the breast milk bank are not paid. The bank does not always have adequate supplies - four donor mothers are needed to supply one baby, so HIV positive babies have priority. We go to moms' groups and chat to them about the project. We screen prospective donors with a questionnaire [covering health and lifestyle] and then teach them how to store the milk. Because breast milk matures with a baby, we try to match milk from a mother with a two-month old baby, with a baby of the same age at the home. It's not always possible, but the breast milk they get is better than none at all, she said. (source: IRIN, 28 October 2003) Link //\// © iThemba Lethu http://www.ithembalethu.org.za