Antiretroviral drugs and breastfeeding
Q.7 If ARVs protect the infant even if the mother does not exclusively breastfeed, is it still important to recommend exclusive breastfeeding in the first 6 months rather than just any breastfeeding?
Yes. Before we learned that ARVs can protect against HIV transmission through breastfeeding, WHO recommended that HIV-infected mothers who breastfeed should exclusively breastfeed for the first 6 months. This was for two reasons:
- No matter whether the mother or infant are taking ARVs, exclusive breastfeeding for the first 6 months is very important for protecting the infant against diarrhoea, pneumonia and malnutrition. Exclusive breastfeeding is much more effective than partial breastfeeding (mixed feeding) at protecting against these infectious diseases.
- In the absence of ARVs, exclusive breastfeeding reduces the risk of HIV transmission by about half. The protection that ARVs provide against HIV transmission is greater than the protection offered by exclusive breastfeeding. It is unlikely that exclusive breastfeeding adds significantly more protection against HIV transmission if the mother or infant is taking ARVs.
Therefore, even if the mother or infant is taking ARVs to protect against HIV transmission, the infant receives significant other benefits from exclusive breastfeeding.