 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Miriam H. Labbok, MD, MPH, FACPM, Senior Advisor, Infant and Young Child Feeding and Care, UNICEF/PD/Nutrition, UNICEF House, Room 756, 3 UN Plaza, East 44th St, New York, NY 10017, 212-326-7368, MLABBOK@UNICEF.ORG
Background There are a few studies that demonstrate that exclusive breastfeed reduces the transmission of HIV from mother to child if compared to more common patterns. Policymakers, health workers and mothers need to understand how, under different conditions, the risk of mother-to-child transmission of HIV through breastfeeding compares with the risk of death due to artificial feeding. Therefore, International agencies must use the best available evidence to decide public health recommendations. Methods Recent models were reviewed and newly disseminated data on HIV transmission with and without ARVs and with and without exclusive breastfeeding. Findings from models are compared to study findings. One model used four feeding and treatment scenarios: 1) no ARV, “normal” BF, 2) Perinatal ARV (PARV), no BF, 3) PARV, 6 mo BF, 4) PARV and 6 mo. EBF Results All models and most studies show that compared with artificial feeding, breastfeeding during the first 6 months by HIV-positive mothers increases HIV-free survival. After 6 months, as the age-specific mortality rate and risk of death due to replacement feeding both decline, replacement feeding appears safer. This impact is additive to the impact of ARVs. Concerns that all the gains of ARVs are defeated by any breastfeeding does not appear to be substantiated at the time of this writing. The latest findings will be presented at the meeting. Conclusions The policy implications of this model, other models and recent studies are used in an ongoing manner to update international guidance. Up-to-date UNICEF guidance will be discussed during this session.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.