VOA健康报道2024--Doctors’ Group: Mothers with HIV Can Breastfeed

Doctors’ Group: Mothers with HIV Can Breastfeed

A top U.S. pediatricians’ group is making a major policy change about breastfeeding by women with HIV.

The group says women infected with HIV can breastfeed their babies as long as they are taking medications that suppress the virus that causes AIDS.

The new report from the American Academy of Pediatrics (AAP) changes guidance the group had in place since the start of the HIV epidemic¹ in the 1980s.

The group said currently available drugs can reduce the risk of spreading HIV through breast milk to less than one percent, said Dr. Lisa Abuogi. She is a pediatric HIV expert at the University of Colorado and lead writer of the report.

“The medications are so good now and the benefits for mom and baby are so important that we are at a point where it is important to engage in shared decision-making,” Abuogi said.

The drugs are known as antiretroviral therapy. They do not remove all risk of spreading HIV through breast milk. Avoiding breastfeeding is the only sure way to prevent spreading the virus, Abuogi said.

Also, parents must only breastfeed for the babies' first six months. Research shows that switching between breast milk and formula can disrupt an infant's digestion² in ways that increase the risk of HIV infection.

About 5,000 people who have HIV give birth in the U.S. each year. Nearly all take drugs to suppress the virus to very low levels, Abuogi said. But viral levels can increase if they do not stay on them.

The medications became widely available starting about 10 years ago. Before then, about 30 percent of HIV infections transmitted from moms to babies occurred during breastfeeding, said Dr. Lynne Mofenson. She is an adviser³ to the Elizabeth Glaser Pediatric AIDS Foundation. In the early 1990s, about 2,000 infections occurred in U.S. infants each year. Today, it is fewer than 30.

The new AAP policy comes more than a year after government agencies changed their advice. The National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) changed their recommendations against breastfeeding by people with HIV. The new guidance said people who have viral suppression should be advised about their choices. Those agencies also said that health care providers should not report to child protective services agencies if a parent with HIV seeks to breastfeed.

Research says breastfeeding provides the best nutrition for babies and protects them against sickness and conditions like obesity⁴ and type 2 diabetes⁵. Nursing also reduces the mother’s risk of breast and ovarian cancer, diabetes and high blood pressure.

The World Health Organization (WHO) has recommended since 2010 that women with HIV in developing countries breastfeed their infants and have antiretroviral therapy. The guidance weighed the risk of infants getting HIV through breastfeeding and the risk of babies dying from malnutrition⁶, diarrhea and pneumonia⁷. In developing countries, safe replacements⁸ for breast milk are often not available.

Dr. Lynn Yee is a Northwestern University women’s health doctor who helped write the NIH guidance. She said experts in developed nations had recommended against breastfeeding. That is because of the wide availability of safe water, formula, and human donor⁹ milk, which could remove the risk of HIV infection, Yee added.

That upset people with HIV, who were not given the choice to nurse.

Ci Ci Covin is a 36-year-old from Philadelphia, Pennsylvania. She said she was told she was infected with HIV at age 20. She said she was not permitted to breastfeed her first child, Zion, who is now 13.

Covin said not being able to nurse her son led to postpartum depression. When she became pregnant with her daughter, Zuri, who is now 2-years-old, health care workers helped her breastfeed successfully for seven months. Covin took her medication, and her baby was given drugs to prevent infection.

“Breast milk has everything in it that my baby would need,” Covin said. “That's a beautiful thing.”

Abuogi said the AAP report provides important guidance for pediatricians, nurses and breastfeeding specialists who work with children and families.

Some providers ignored the earlier recommendations and helped women being treated for HIV to nurse their babies. The new guidance should expand such nursing, hopefully quickly, Abuogi said.

I’m Dan Novak.

Words in This Story

pediatrician — n. a doctor who treats children

benefit — n. a good result that comes from doing a certain thing

engage — v. to carry out or to do

formula –n. artificial mother’s milk

disrupt –v. to interfere¹⁰ with a process or activity

digestion –n. the process of consuming and processing nutrients¹¹ and removing waste

obesity — n. the condition of being very overweight

nurse –v. to breastfeed a baby

postpartum — adj. taking place after childbirth

1 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

2 digestion   

n.消化，吸收

参考例句：

• This kind of tea acts as an aid to digestion.这种茶可助消化。
• This food is easy of digestion.这食物容易消化。

3 adviser   

n.劝告者，顾问

参考例句：

• They employed me as an adviser.他们聘请我当顾问。
• Our department has engaged a foreign teacher as phonetic adviser.我们系已经聘请了一位外籍老师作为语音顾问。

4 obesity   

n.肥胖，肥大

参考例句：

• One effect of overeating may be obesity.吃得过多能导致肥胖。
• Sugar and fat can more easily lead to obesity than some other foods.糖和脂肪比其他食物更容易导致肥胖。

5 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

6 malnutrition   

n.营养不良

参考例句：

• In Africa, there are a lot of children suffering from severe malnutrition.在非洲有大批严重营养不良的孩子。
• It is a classic case of malnutrition. 这是营养不良的典型病例。

7 pneumonia   

n.肺炎

参考例句：

• Cage was struck with pneumonia in her youth.凯奇年轻时得过肺炎。
• Pneumonia carried him off last week.肺炎上星期夺去了他的生命。

8 replacements   

n.代替( replacement的名词复数 )；替换的人[物]；替代品；归还

参考例句：

• They infiltrated behind the lines so as to annoy the emery replacements. 他们渗透敌后以便骚扰敌军的调度。 来自辞典例句
• For oil replacements, cheap suddenly looks less of a problem. 对于石油的替代品来说，价格变得无足轻重了。 来自互联网

9 donor   

n.捐献者；赠送人；(组织、器官等的)供体

参考例句：

• In these cases,the recipient usually takes care of the donor afterwards.在这类情况下，接受捐献者以后通常会照顾捐赠者。
• The Doctor transplanted the donor's heart to Mike's chest cavity.医生将捐赠者的心脏移植进麦克的胸腔。

10 interfere   

v.(in)干涉，干预；(with)妨碍，打扰

参考例句：

• If we interfere, it may do more harm than good.如果我们干预的话，可能弊多利少。
• When others interfere in the affair,it always makes troubles. 别人一卷入这一事件，棘手的事情就来了。

11 nutrients   

n.（食品或化学品）营养物，营养品( nutrient的名词复数 )

参考例句：

• a lack of essential nutrients 基本营养的缺乏
• Nutrients are absorbed into the bloodstream. 营养素被吸收进血液。 来自《简明英汉词典》