Can You Breastfeed If You Are HIV Positive?

The Transmission of The Human Immunodeficiency Virus Through Breast Milk

When safe alternatives are available, breastfeeding is not recommended for HIV positive mothers. Henry Chaplin/E+/Getty Images

What is HIV?

The human immunodeficiency virus (HIV) is a serious infectious disease that can be passed from mother to child through breastfeeding. Without any treatment, 15% to 25% of HIV positive mothers pass the virus to their children during pregnancy and childbirth. The risk of transmission goes up with breastfeeding. This is why HIV screening along with good prenatal care during pregnancy is so important.

If a mother tests positive for HIV while she is pregnant, she can be treated with antiretroviral medication to help protect her own health and reduce the risk of transmitting the virus to her baby.

Breastfeeding and HIV

In the United States, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) do not recommend breastfeeding for women who test positive for HIV. The HIV virus does enter the breast milk and it can be transferred to the baby during breastfeeding. Here in the US, and in other countries where safe alternatives for infant nutrition are available, the risk of passing the virus to the baby can be avoided by not breastfeeding.

There are, however, areas of the world where it may be beneficial for HIV positive mothers to breastfeed. In places where infant death rates are high - due to poor nutrition, illness, and disease - breastfeeding may make all the difference in a child's ability to survive even if the baby's mother has HIV.

The decision to breastfeed or not to breastfeed is much more difficult in these places.

Some studies show that the risk of passing HIV to the baby is less when a mother does not breastfeed at all, or when she breastfeeds exclusively along with the use of antiretroviral medications. However, the risk of transmitting the virus to the baby is greater when a mother combines breastfeeding with formula feeding.

This information helps to determine the feeding options available for HIV positive women.

Infant Feeding Options For HIV Positive Mothers:

  • If available, you can give your child a safe, infant formula.
  • Ask your doctor for a prescription to obtain donor breast milk from a Human Milk Bank.
  • Use breast milk from a healthy, HIV negative donor.
  • Where resources are not readily available, learn the proper procedure for flash-heating breast milk.
  • Breastfeed exclusively with the use of antiretroviral medications for the first 3 months.

Overall, the decision about whether or not an HIV positive mother should breastfeed depends on her location, the availability of resources, her health, and the health of her child. All HIV positive women should be given counseling, information, and support so that they can make the best choice for their individual situation.



American Academy of Pediatrics.  Policy Statement. Breastfeeding and the Use of Human Milk. Section on Breastfeeding. Pediatrics Vol. 129 No. 3 March 1, 2012 pp. e827 - e841:

Israel-Ballard, K., Donovan, R., Chantry, C., Coutsoudis, A., Sheppard, H., Sibeko, L., & Abrams, B. Flash-heat inactivation of HIV-1 in human milk: a potential method to reduce postnatal transmission in developing countries. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2007; 45(3): 318-323.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Sixth Edition.  Mosby. Philadelphia. 2005.

United States Centers for Disease Control and Prevention. Breastfeeding: Human Immunodeficiency Virus (HIV) and Aquired Immunodeficiency Virus (AIDS):

World Health Organization. WHO Guidelines on HIV and Infant Feeding: An Updated Framework for Priority Action. 2010

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