April 2001
Breastfeeding with HIV: Yay! Or Nay! In the U.S. of A.

There is so much to consider when you have HIV and are becoming a new mom. What’s best for this child? What’s best for me the mother? What are my values? The list of questions alone could fill this whole article. They are all important and should all be seriously considered while you’re pregnant so you have a plan when the baby comes.

Whether or not to breastfeed is one question you probably won’t have to make. Here in the US, the medical recommendations are that you not breastfeed. This can be a huge loss depending on what you were taught. In past generations when modesty equaled respectability, breastfeeding was not always popular. Today, however, we know that breastfeeding is the first choice for providing your new baby with disease-preventing antibodies and proper nutrition. We know that breastfeeding further strengthens the bond between mother and child. We also know that HIV is spread through breast milk.

HIV has been isolated in breast milk. It is found in lower concentrations in colostrum, or the first milk, but it is still there. The chance of HIV being passed to the infant through breast milk ranges from 14% to 26%, depending on a number of circumstances. If you were in a developing country, you might have to take that risk, but in the US formula and clean water are more accessible. If you are concerned with the cost of formula, talk to your case manager. There are programs to help ensure that babies get proper nutrition.

It is recommend that you stop the flow of milk as soon as possible to make your decision not to breastfeed easier and more comfortable. The best way to do this is to tightly bind your breasts. Binding is easy; just tightly wrap and tie a strip of cloth (maybe an old sheet torn in strips) around you (for greatest comfort tie in front). It may sound a little uncomfortable, but it really isn’t, and it’s only for a few days. Depending on your milk production, you may need to express (or pump) some milk, to prevent breasts from becoming swollen, hard, and painful. Talk to your provider about this. Express or pump as little as possible to avoid stimulating more milk production. Sometimes people want to pasteurize (a heating process used to kill germs) their milk. This isn’t a good idea, because while you may destroy HIV, you are also destroying the good stuff in breast milk (antibodies and much of the nutritional value).

So what do new moms do to deal with the loss of breastfeeding? Talk openly with your care provider about your concerns. Talk to other women who haven’t breast fed to relieve your fears. If you haven’t disclosed, or your family is big on breastfeeding, come up with a plan and an explanation before the baby comes. Collect fun baby bottles. Purchase or make a sling that will carry the baby close to you as you’re doing chores. Most importantly spend lots and lots and lots of time holding, cuddling, and talking to your new baby. Plan to give yourself that time; they are tiny for only a little while. I even read to my baby, because I ran out of things to say, and believe you me we are as bonded as any mother and child can be.

La vida con el VIH o el SIDA es penosa sin duda. Por favor no la hagas peor con dejar de tratar la depresión. Identifica cuales de estos síntomas notas en ti misma y muéstrale la lista al/a la doctor/a la próxima vez que consultes con él/ella.

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