Human Immunodeficiency Virus (HIV) with regards to breastfeeding

HIV is spread through direct contact with bodily fluids. In North America, those who test positive for any type of HIV are advised not to breastfeed or donate breastmilk by the CDC.

In a 2008 training package the CDC however also stated that “HIV is killed by heating the milk and ends the risk of transmitting HIV through breast milk.” This poses the question as to whether the recommendations of the CDC for those who are HIV positive to not breastfeed their baby, without qualifying and allowing for the opportunity to make informed decisions with the guidance of a health care provider, is in the best interest of the parent/child in all situations.

Please see ‘HIV and the global context of infant feeding’ for a more in-depth look at the WHO’s standpoint on HIV and breastfeeding.

Donors should avoid high-risk behaviours –i.e. I.V. drug use, unprotected sex with someone of unknown status– that may lead to an HIV infection. Donors should also be aware of the fact that they may not know the status of their partner. Regular blood screening is recommended by milk banks.

In the US, as well as in many other countries, HIV is part of routine testing during pregnancy or during labor. A copy of the results can be obtained through your health care provider. There are many methods for HIV testing available, you can read about them here.

The CDC states that the risk of HIV transmission by mistakenly feeding a child milk with another child’s bottle is believed to be low because:

  • “In the United States, women who are HIV positive are advised NOT to breastfeed their infants,
  • Chemicals present in breastmilk act, together with time and cold temperatures, to destroy the HIV present in expressed breastmilk,1
  • Transmission of HIV from single breastmilk exposure has never been documented.”

If there is any doubt regarding the donor’s HIV status or for added protection, it is possible to flash-heat breastmilk at home in order to deactivate HIV.

Please consult with a qualified health care provider with any HIV related issues.

See a more in depth discussion about this topic in ‘HIV and the global context of infant’.

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  1. Wouldn’t it be nice to know the time frame and to see the research on this to see how effective time and temperature really are? Destroy is a strong word, but if it is true, wouldn’t HIV positive moms deserve to know? The transmission of HIV from an infected mother to her infant through continuous breast feeding is 5-8%. Combined with ARV treatment and specific storage guidelines, the risks would be drastically diminished. We contacted the CDC about this for a citation with no response to date unfortunately. []

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