In an American Academy of Pediatrics clinical report published online May 20 in Pediatrics, recommendations are presented for breastfeeding among people living with and at risk for HIV.
Lisa Abuogi, M.D., from the University of Colorado School of Medicine in Aurora, and colleagues examined feeding practices for infants born to people living with and at risk for HIV infection.
The authors note that care team members should be aware of the HIV transmission risk via breastfeeding and the recommendations for feeding infants with perinatal HIV exposure. The estimated risk for HIV transmission via breastfeeding is less than 1 percent from a parent with HIV who is receiving antiretroviral treatment (ART) and is virally suppressed. The only infant feeding option with 0 percent risk for HIV transmission is avoidance of breastfeeding. However, people with HIV may want to breastfeed; a family-centered, nonjudgmental, harm reduction approach should be offered to people with HIV on ART with sustained viral suppression below 50 copies per mL who want to breastfeed. Recommendations against breastfeeding are advised for people with HIV who are not on ART or who are on ART but without viral suppression. HIV testing is recommended for all pregnant persons, and HIV preexposure prophylaxis is recommended to pregnant or breastfeeding persons at high risk for HIV acquisition.
“Pediatric health care professionals should be prepared to provide infant feeding counseling and a family-centered, culturally sensitive, harm reduction approach for people with HIV on ART with sustained viral suppression who desire to breastfeed,” the authors write.
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