HIV-Infected Mothers Must Decide On Breastfeeding

Ghana's HIV-infected mothers must decide on breastfeeding as the country has no across-the-board policy on the issue of HIV transmission and breast-feeding, a doctor said in Accra Friday.

"An HIV-positive mother, after receiving counselling and information from trained health officials, is left to make a choice on whether to breast-feed her child," Dr Kwaku Yeboah, Manager of the National AIDS Control Programme, said.

He told the Ghana News Agency in Accra that said there is a 30 to 40-percent risk of an infected mother passing on the virus to her child.

He said children of less than one year account for four percent of the total population and 15 percent of HIV cases in Ghana. The threat of eroding the gains made in reducing infant mortality is therefore enormous.

In sub-Saharan Africa, recommendations from health authorities on the issue of breast-feeding and HIV infection are not clear. Since childhood diseases are common and HIV testing is often not available, most women have been encouraged to breast- feed regardless of their HIV status, he said.

"What we are advising is that every pregnant woman should make it a point to find out about her HIV status to enable her to make the proper decision on the issue.

"All state hospitals have been equipped with HIV-testing and counselling facilities and every pregnant woman is being encouraged to go in for testing."

Yeboah said breast-feeding is promoted heavily by health workers in poor countries because it affords viral protection against deadly childhood diseases, particularly diarrhoea and respiratory infections, which are far more common than HIV.

Besides being free, breast-feeding is nutritionally richer than industrial baby foods, which though are costly, may not provide the needed balanced diet because in some cases, mothers mess up the feeding formula.

In other cases clean water to prepare it is often beyond the means of families in developing countries.

There is, however, a mounting concern in countries in Africa over transmission of HIV by infected mothers. Transmission from mother-to-child occurs during pregnancy, delivery and breast- feeding.

In 1999, 430,000 children under 15 died of AIDS in Africa out of a global total of 480,000. Out of the global total of 620,000 for the same year, 515,000 kids were newly infected with the virus on the continent.

The Joint UN Programme on HIV/AIDS or UNAIDS now encourages as much information as possible on the relative risk of breast-feeding and infant formula feeding to be made available to HIV positive mothers, requiring that they be tested, to enable them to decide for themselves whether to breast-feed or not.

In most poor countries, however, most women still are not provided with sufficient information and support to make an informed choice.

Yeboah said it is not every mother who passes the disease on to the child. Some babies, for some inexplicable reasons, escape being infected, he said.

Health officials said mother-to-child transmission varied and depended on the viral load being carried by the mother, how strong the child is, birth weight and how sick the mother is or her general health status.

Yeboah said because of fear and stigmatisation, people do not willingly go in for testing. "But thorough counselling equips them to stand against all types of stigmatisation," he added.

Sally Ethelston of the US-based Population Action International, an advocacy organisation, said the benefits of breast-feeding outweighed the risk of HIV transmission.

"This is because for resource-poor parts of the world, the cost of formula and the danger of polluted water, threatens the survival of the child," she added. "It is a question of choosing between two evils, neither of which is risk-free, with issues such as diarrhoea and malnutrition, breastfeeding is still the best but not withoutrisk."