Breast milk includes a powerful anti-retroviral

Breast milk is the first choice when it comes to nourishing a baby. Mother Nature is able to blend the right combination of nutrients, along with a few very helpful extras, that leaves baby & friends perfectly nourished, while helping Mom have a more “peaceful” night.

But for an HIV Mom, the very same nourishing breast milk, has the potential to transmit the virus to her little one.

Go with formula or go fresh?

For many, the answer is a no brainer – formula is clearly the best choice.

This is why many governments in developing countries routinely provide free formula to HIV mothers.

But, in a germ infested neighbourhood – formula is not always best. Formula fed babies are a lot more vulnerable to intestinal and respiratory infections, infections that can easily prove fatal.

The increased vulnerability, is because in addition to nutrients, breast milk includes an armoury full of powerful antibodies and other immunologically bioactive compounds, which help keep these kinds of infections controlled.

So could fresh still turn out to be best ?

Going fresh less risky

The stats suggest that despite the universal presence of HIV in human breast milk, only a fraction of baby’s actually contract the virus from drinking their mother’s milk.

Anti-retrovirals narrow the odds, but even without these drugs, only 10-15 % of baby’s contract the virus.

Something in breast milk provides protection, an international team of experts set out to find the secret ingredient.

Fighting HIV transmission

The team of researchers began the hunt for the mystery ingredient, by obtaining breast milk samples from 200 Zambian women.

The women had all given birth to HIV negative infants, but their HIV status meant, their baby’s would continuously be exposed to the virus, as they consumed the breast milk.

NOTE :

At the time, these women did not have access to anti-retroviral therapies, so their little ones had no additional pharmacological protection. Something that is routinely provided today to HIV positive Moms.

The team monitored the health and HIV status of the babies from 0 to 24 months, a handful of babies contracted HIV.

Breast milk fights back

Human milk contains fats, proteins and carbs. The carbohydrate component includes oligosaccharides – relatively short chains of sugars linked together.

These oligosaccharides which are found in milk, referred to as human milk oligosaccharides (HMOs) are not something that a baby is able to digest. So they tend to accumulate and end up covering the surface of the gut.

This coating on the mucosal surface does several helpful things –

the highly concentrated “sticky” layer protects the delicate cells underneath, providing physical protection and keeping inflammation levels low
the layer also provides good bacteria with food to eat i.e. prebiotic, allowing them to grow and thrive, lots of “good” bacteria, thwart the bad guys from growing. Microflora spoon

HMOs protect agains HIV transmission

It is these sugars in breast milk that provide protection.

Mom’s with higher concentrations of these HMO in their milk, were less likely to pass the virus onto their little one.

Unfortunately, the researchers did not try to figure out why some Moms had more than others – so we don’t really know how to increase their levels, just yet. But, researchers are working on ways to produce them in the lab, so maybe one day, Mom’s who are short, will be able to get a little extra.

Breast is best

Being breast fed gives a baby a fabulous start, by providing all the nutritional goodies a growing human needs, as well as feeding baby’s first friends. And those early friends count !

If you can, strive to breast feed your little one. The ingredients packaged in breast milk are able to protect against some really nasty bugs, including HIV.

NOTE : For HIV positive Mom’s it is a difficult decision. You need to discuss it with your physician and carefully weigh up the risks and benefits, there is no right or wrong answer.

The two factors to consider when making the decision :

Your overall health – this is going to impact the quality of the milk you produce.
Your viral load – the higher the number of viruses circulating in your body, the more likely it is, that those viruses make the jump to your baby. This is where ARVs can help – they can’t cure AIDS, but they can keep the virus in check, so the levels circulating in your body are low.

Human milk oligosaccharide concentration and risk of postnatal transmission of HIV through breastfeeding. American Journal of Clinical Nutrition (2012) 96(4):831-839. Lars Bode, Louise Kuhn, Hae-Young Kim, Lauren Hsiao, Caroline Nissan, Moses Sinkala, Chipepo Kankasa, Mwiya Mwiya, Donald M Thea, and Grace M Aldrovandi.

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