Babies born HIV negative were 11 times
more likely to become infected by their HIV positive mothers if given both
breastmilk and solids in their first six months than those who were only fed
In addition, babies who are exclusively
breastfed have a much lower risk of death from other infectious diseases such as
diarrhoea in the first three months than those that are formula fed.
Professor Nigel Rollins, lead
investigator from the University of KwaZulu-Natal, said the problem with current
government policy was that simply giving free formula milk in many cases results
in mixed feeding.
But mixed feeding is the worst
outcome being associated with increased transmission and increased mortality.
Replacement feeding, even when exclusive is associated with increased
non-infectious diseases and death especially in the first six months, said
The question of how HIV positive
mothers should feed their babies has been hotly contested by AIDS researchers,
as HIV can be transmitted in breastmilk.
Many of those from wealthier countries
believe that HIV positive mothers should only give their babies formula milk,
but this is not practical in places where mothers don't have clean water.
Rollins said there should be a review
of government's infant feeding policy following his study. As a study
group we feel that women are driven or unduly drawn to replacement feeding by
the offer of free formula and that they should be offered an equivalent
'incentive' to exclusively breastfeed such as nutrition support to the mother
This would enable her to gain
benefit herself and the child would be protected from diarrhoea with relatively
minimal risk for HIV transmission he said.
Rollins added that they would endorse a
transition to replacement feeding at six months if the mother has adequate
support available to feed the child safely at that time, as the risk diarrhoea
was less and the babies needed food in addition to breastmilk to grow and
Meanwhile, another South African study
found that mothers' decisions to use formula milk were not based on whether she
had easy access to clean water adequate fuel to boil water or whether she was
employed or had disclosed her HIV status.
This means that [infant feeding]
counsellors are not taking these socio-economic factors into consideration as
required in the World Health Organisation criteria, said Tanya Doherty of
the Medical Research Council/Health Systems Trust.
The study concluded that infant HIV
free survival could be improved if women choosing to formula feed had access to
piped water, fuel and had disclosed their HIV status.
Without these, a choice to
exclusively breastfeed would result in a better outcome, said Doherty.