Julie, thanks for sending along details of the
Huffington Post article on prevention of
mother-to-child transmission of HIV. It's good
to see this topic is being given exposure in this
mainstream publication. And great to see that up
to date guidance is reported and even a pic of a
baby breastfeeding, as you mention. Yes, the
importance of maternal antiretroviral therapy
from early pregnancy is to to reduce her viral
load to undetectable so that transmission during
birth and during breastfeeding can be reduced to
0-1%. For this to happen, there has indeed been
recognition that getting the father on board
means that the mother can take her meds openly
and that he can help defend the need for the baby
to be exclusively breastfed against input from
the grandmothers, aunties and other family
members who traditionally control infant feeding
and believe that little sips of water and little
mouthfuls of porridge are necessary to the baby's health.
Interestingly, the focus on fathers is nothing
new. In the past when avoidance of postnatal
transmission hinged on avoidance of breastfeeding
(before it was found that formula killed more
babies than HIV) the focus on the need for
"couples counselling" was so that the father
would be more accepting of "replacement-feeding"
(formula-feeding)..... likewise the need for
"community support" was promoted for the same reason.
There was only one small mis-reporting that I
could see in the article, and that's near the
end, but I think it's important to identify
it. It's implied that an HIV+ mother would stop
taking her antiretroviral meds when breastfeeding
ends. The most up to date WHO recommendation
(WHO 2013, Consolidated guidelines on the use of
antiretroviral drugs for treating and preventing
HIV infection: Recommendations for a public
health approach, (available
at
<http://www.who.int/hiv/pub/guidelines/arv2013/download/en/index.html>http://www.who.int/hiv/pub/guidelines/arv2013/download/en/index.html
) is that all women diagnosed as HIV+ should
receive full antiretroviral therapy from
diagnosis (hopefully before or during early
pregnancy) and that this should be continued for
life. This recommendation makes so much sense -
to protect not only against mother to child
transmission, but also to constitute
treatment-as-prevention against further sexual
transmission and protect future children. Not
least, it improves the mother's health and allows
her to live a normal lifespan, rather than
limiting treatment to the time of pregnancy and
breastfeeding as used to happen - in effect
effectively treating her as just an incubator of uninfected children.
Pamela Morrison IBCLC
Rustington, England
-----------------------------------------------
Date: Sun, 15 Jun 2014 17:19:48 -0700
From: the juliest person you know <[log in to unmask]>
Subject: HIV, pregnancy, breastfeeding
http://www.huffingtonpost.com/2014/06/15/hiv-couple-kids_n_5492198.html?ncid=txtlnkusaolp00000592
The article discusses the importance of the
woman's significant other being involved in HIV
testing and treatment in terms of not passing
along the virus to their children. While the
article does not mention breastfeeding, in the
first picture, the mother is clearly
breastfeeding the youngest child. Julie Tardos
==== Gold were as good as twenty orators, and
will, no doubt, tempt him to anything. Richard III, act IV, scene II
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