Global Advanced Research Journal of Microbiology (GARJM) ISSN: 2315-5116
December 2023, Vol. 1(1), pp. 001-008
Copyright © 2023 Global Advanced Research Journals

Full Length Research Paper

Breastfeeding and HIV/AIDS: Balancing Infant Nutrition and Maternal Health in the Context of Global HIV Prevention

Akpede Anthony Akpevwe¹, Imaobong Rita Solomon², Johnson Uyovwiesevwa³

1MSc Biomedical Health, University of Derby, United Kingdom
Bachelors of Science Laboratory Technology. (BSLT), Biomedical Technology Option, Delta State University, Abraka, Nigeria.
Associate: Nigeria Institute of Science Laboratory Technology. (ANISLT)
2 HND, Health and Safety Management, Lagos City, Polytechnic, Nigeria
MSc, Strategic Procurement Management, University of South Wales, United Kingdom
3PhD, Doctor of Physiology, Delta State University, Nigeria
MSc Public Health, Obafemi Awolowo University, Nigeria
Bachelor of Medicine, University of Benin Teaching Hospital, Nigeria.

*Corresponding Author E-mail: jecintaken@gmail.com

Accepted 04 January, 2023 

Abstract

Breastfeeding is universally recognized as the gold standard for infant feeding and survival, offering an irreplaceable combination of nutritional adequacy, immunological protection, and psychosocial benefits that no artificial substitute can fully replicate. It supplies all the macronutrients and micronutrients required for optimal infant growth, while also delivering antibodies, enzymes, and bioactive factors that strengthen the developing immune system and protect against early childhood illnesses such as diarrhea, pneumonia, and sepsis. Beyond biological benefits, breastfeeding fosters mother–infant bonding, supports cognitive development, and reduces the risk of long-term health complications such as obesity and type II diabetes. Consequently, the World Health Organization (WHO) and UNICEF strongly recommend exclusive breastfeeding for the first six months of life, followed by continued breastfeeding with safe complementary feeding for at least two years and beyond (Ken-Jabin, 2015). For women living with HIV, breastfeeding introduces a profound and often distressing dilemma. Breast milk, while nutritionally indispensable, is also a potential vehicle for HIV transmission. Without preventive interventions, breastfeeding contributes substantially to mother-to-child transmission (MTCT), which remains the primary source of pediatric HIV globally. Each year, an estimated 1.3 million women living with HIV give birth, and approximately 150,000 children acquire HIV, with breastfeeding accounting for a significant proportion of these new infections (Ken-Jabin, 2015). Research in Delta State, Nigeria, demonstrates that adherence to antiretroviral therapy (ART) and structured counseling can significantly reduce MTCT rates, even in settings where breastfeeding is culturally expected and formula feeding is often inaccessible or socially discouraged (Ken-Jabin, 2015). The challenge is particularly pronounced in sub-Saharan Africa, where HIV prevalence is high and breastfeeding is nearly universal. In many communities, refusal or early cessation of breastfeeding is often perceived as suspicious, potentially disclosing maternal HIV status and exposing women to stigma or social isolation. Safe and affordable alternatives, such as commercial infant formula, are frequently inaccessible due to financial constraints, inadequate supply chains, and unreliable access to clean water. Replacement feeding, while eliminating the risk of HIV transmission, often exposes infants to life-threatening conditions, including malnutrition, diarrheal disease, and respiratory infections (Ken-Jabin, 2015). Thus, HIV-positive mothers in resource-limited settings are confronted with a double burden: the biological risk of transmitting HIV through breastfeeding, and the equally severe risk of exposing their infants to preventable illness and death through unsafe replacement feeding. This paradox creates a complex intersection of medical, cultural, and socio-economic challenges, making the question of infant feeding one of the most critical and sensitive dimensions of global   HIV  prevention  and  maternal-child  health  (Ken-Jabin, 2015). A narrative review design was employed, synthesizing evidence from peer-reviewed literature published between 2000–2023, global datasets from WHO/UNAIDS, and observational data from maternal-child health clinics in Delta State, Nigeria. Studies addressing feeding methods, ART coverage, mother-to-child transmission (MTCT) risk, and infant survival outcomes were included. Field observations explored maternal decision-making, stigma, ART adherence, and socio-economic constraints influencing feeding practices. Evidence indicates that without maternal ART, breastfeeding contributes to a 10–20% risk of MTCT. With ART and exclusive breastfeeding, transmission risk declines to below 2%. Exclusive breastfeeding offers lower transmission risk compared to mixed feeding, which increases gut mucosal vulnerability and viral susceptibility. Replacement feeding prevents HIV transmission but is associated with higher infant mortality (15–25%) from diarrhea, respiratory infections, and malnutrition in low-resource contexts. Observations from Nigeria highlighted maternal anxiety, fear of stigma, and ART adherence challenges, particularly among young and low-income mothers. Infants of mothers adhering to ART and practicing exclusive breastfeeding demonstrated better growth and survival outcomes compared to infants exposed to mixed feeding or poorly supported formula use. Exclusive breastfeeding combined with sustained maternal ART is the most effective and practical strategy for HIV-positive mothers in low-resource settings. Policies should strengthen ART supply chains, implement culturally sensitive and family-inclusive counseling, and provide socio-economic support for vulnerable mothers. Eliminating paediatric HIV requires integrated maternal-child health services, stigma reduction strategies, and longitudinal research on ART-exposed infants to ensure safe and sustainable outcomes.

Keywords: Breastfeeding and HIV/AIDS, Infant Nutrition, Maternal Health, Global HIV Prevention.

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Incorporate culturally sensitive, family-inclusive education.
Ensure uninterrupted ART supply chains.
Conduct longitudinal studies on ART exposure in breastfed infants.

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