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What World Breastfeeding Week Means for HIV Positive Mothers

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Anne Coutsoudis

The last 20 years or so have been very difficult years for HIV-infected mothers and health-care workers because of the huge dilemma around infant feeding. Mothers faced the situation of a chance of infecting their child if they breastfed. This fear drove international agencies and many countries to promote formula feeding and even distributed it for free, leading to many HIV-infected women opting for formula feeding. Soon the toll of this policy began to be felt, as formula fed infants began to succumb to malnutrition and death from diarrhea and pneumonia.

Many of us scientists were desperate to find a way out for HIV-infected mothers and find ways of making breastfeeding safer. Slowly the research began to provide answers -- the first glimmer of hope was the evidence that exclusive breastfeeding in the first six months (as opposed to mixed breastfeeding) considerably reduced the risk of HIV transmission. More recently, strong evidence was provided that if mothers received ARVs during the breastfeeding period, the infant was very unlikely to become infected. This was a huge breakthrough and led to WHO and UNICEF strongly recommending breastfeeding for HIV infected mothers, provided they were receiving ARVs and being encouraged to practice exclusive breastfeeding in the first six months.

After years of working with HIV-infected mothers and their children and seeing their pain of either having to deny their infants the right to breastfeeding or having to feel guilty about breastfeeding this is victory time for me.

What a happy time to be able to watch HIV-infected mothers confidently enjoying the intimacy of the mother-child bond. Apart from the well-documented benefits for the child, there are also wonderful benefits for the mother as well. For example, during breastfeeding mothers produce the hormone oxytocin, which is a "feel good" hormone, leaving mothers less likely to become depressed. Additionally, the breastfeeding mother is at reduced risk for breast and ovarian cancer.

A strange stigmatization of breastfeeding as abnormal, disgusting or backward has also crept into society. All too often, from across the globe, we still hear stories about mothers who are prevented from breastfeeding in public areas, and this even in cities and states where breastfeeding in public is a legally enshrined right! The online space mirrors this same stigmatization of breastfeeding. There are enough examples of mothers who've protested social media platforms banning pictures of them nursing their babies. Yet, these same platforms have been happy to display the naked female breast. The message one gets from this is that it's okay to have the female breast on display, just don't have an infant attached to it!

Infant food companies and their marketing juggernaut of attractive and convincing advertisements which undermine the scientifically proven superiority of human milk over their artificial substitutes have succeeded in pushing breast milk and breastfeeding to the margins of many societies.

As important as babies receiving breast milk is the support and encouragement that mothers need from their support system: families, healthcare providers, communities and society at large, in order to breastfeed. Meaningful support requires that this support system is well informed about breastfeeding and that private and public spaces are conducive to nursing mothers and their babies. I want to encourage communities to support mothers to be able to breastfeed confidently and to prevent the infant food companies from unscrupulously putting pressure on mothers (and health care workers) to give their babies formula milk and baby foods before the age of six months.

Our children are our future and each of us -- peers, health workers, legislators -- has a responsibility in whatever way we can to allow these children to grow up healthy, as they were created to be.