Calling colleagues in Australia. I'm working on an HIV and infant
feeding update, and came across this statement from ABA dated
December 2011. I'm wondering if there has been any
progress?? Thanks if anyone can help.
Pamela Morrison IBCLC
Rustington England
-------------------------------------------
From page 11, Australian Breastfeeding Association Draft Infant
Feeding Guidelines for Health Workers
Submission from the Australian Breastfeeding Association December
2011 available at
<https://www.breastfeeding.asn.au/system/files/ABA%20submission%20re%20Infant%20Feeding%20Guidelines.pdf>https://www.breastfeeding.asn.au/system/files/ABA%20submission%20re%20Infant%20Feeding%20Guidelines.pdf
(accessed 13 March 2013)
Breastfeeding and HIV
The draft Guidelines state on page 106 that, in Australia, women who
are HIV positive are advised not to breastfeed and refer to
statements issued by two United States bodies in 2006 and 2008. There
is no reference to more recent statements, or more recent research.
In this regard, we note that in a recent large study with extensive
follow-up, no cases of postnatal transmission occurred among women
adherent to antiretroviral prophylaxis/therapy (ART) (Shapiro RL,
Hughes MD, Ogwa A, Kitch D, Lockman S, Moffat C et al, Antiretroviral
regimens in pregnancy and breastfeeding in Botswana; N Engl J Med
2010: 362: 2282-2294). This study, along with similar research
findings, prompted the World Health Organization to release new
Guidelines on HIV and Infant Feeding in 2010, which contained revised
principles and recommendations for infant feeding in the context of HIV.
In response to this, feeding guidance issued in 2011 by the British
HIV Association and Children's HIV Association recognises that a
woman on effective triple ART, with a repeated undetectable viral
load at delivery may, after careful consideration, choose to
exclusively breastfeed for the first 6 months of her baby's life. In
view of this more recent research, ABA urges the NHMRC to revise the
Guidelines to enable women who are HIV positive to make informed
decisions in relation to infant feeding, and to equip health workers
with appropriate information to permit this to occur.
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