Kristen Lucier here, and I am a Junior II nursing student at the University of North Dakota. I am interested in expanding my knowledge about the topic of HIV-1-infected breast feeding mothers. My opinion is that although there is evidence connecting a higher rate of HIV-1 transmission to infants through breast milk, it may be more beneficial to advise the mother to breast feed if they are in a low-resource environment. Of course, as with everything in nursing there is no one set course of action that would be best, therefore, I understand it is most important to educate the client, allowing them to make an informed decision. According to Mbori-Ngacha, Nduati, John, Reilly, et al (2001), the risk of transmission of HIV-1 was three-fold higher among breast fed infants. However, other factors come into play that could cause more harm to the baby than good. On the other hand, the authors concluded that there was no increase in mortality among breast fed infants.
One downfall I found in this study is that the formula feeding group was given all the resources, which they may not have otherwise had. Therefore, the results given about the difference in nutritional status is not reality based, but it does offer an argument for the need of government to provide the proper resources for formula feeding to HIV-1 mothers. Guay (2001) points out that formula feeding may lead to malnutrition, which would increase child morbidity and cause other significant problems that the above article was not able to address. This would mean that many more problems with formula feeding could have been detected had the mothers used their own resources, such as unclean water. It seems that since there are so many benefits of breast feeding and there is found to be no increased mortality rate, that breast feeding would be the best option for a low income family.
Newell (2001) suggests that breastfeeding heightens the mortality among mothers. But, can the cause of death be linked to breastfeeding? Couldn’t the higher mortality rate be due to other causes?
As a student, it would be interesting to hear what your opinions are on this issue and if you’ve come across it yet in the clinical setting. What safe alternatives to breast feeding could be made available to HIV-1-infected women in low resource settings?
Reference List
Guay, L.A, & Ruff, A.J. (2001, November 21). HIV and infant feeding—an ongoing challenge. JAMA, 286, 2462-2464.
Newell, M.L. (2001, May 26). Does breastfeeding really affect mortality among HIV-1 infected women? The Lancet, 357, 1634-1635.
Mbori-Ngacha, D., Nduati, R., John, G., Reilly, M., et al. (2001, November 21). Morbidity and mortality in breastfed and formula-fed infants of HIV-1 infected women: a randomized clinical trial. JAMA, 286, 2413-2420.
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