From the mother’s perspective
Q.59 How long should a mother breastfeed? The guidelines talk about 6 months of exclusive breastfeeding but 12 months of other breastfeeding.
In settings where national authorities recommend breastfeeding and ARVs, all mothers are recommended to exclusively breastfeed for the first 6 months of life. HIV-infected mothers are advised to continue breastfeeding up to 12 months while adding adequate amounts of nutritious and safe complementary foods once the infant completes 6 months. Twelve months of breastfeeding is recommended as it balances obtaining the maximum benefits of breastfeeding for survival with the small risk of HIV transmission from breastfeeding when ARVs are taken, and the difficulties of ensuring adherence to ARVs over a longer period. A mother may consider how long to breastfeed based on whether she has the means to safely feed the child without breast milk, and should be aware of the possible implications to the child’s health, and possibly to her family planning method of choice.
Infants of HIV-infected mothers who are taking lifelong ART will be protected against HIV transmission as long as maternal adherence to treatment remains good. This gives the mother greater flexibility as to when to stop breastfeeding. However, in general it is better for an HIV-infected mother to stop breastfeeding around 12 months of age when there are good options for replacing breastfeeding with animal milks and other household foods.