Doctors and HIV positive mothers face difficult life and death choices

Everyday, doctors and thousands of Batswana HIV positive mothers have to make the difficult choice between risking infecting babies by breast feeding them or exposing them to death by giving them formula milk.
The MASHI study by the Harvard AIDS Institute and the Ministry of Health revealed that breast fed babies are more likely to be infected by the HIV\AIDS virus while formula fed babies are more likely to die from diarrhea.
The new research’s evidence suggests that most of the more than 400 Batswana infants who died last year may have been as a result of inappropriate feeding choices – a result of the decision to give them formula milk in an attempt to avoid HIV\AIDS transmission through breast feeding.
The Director of the Botswana HSPH AIDS Initiative Partnership for HIV Research and Education Project, Dr Joseph Makhema, told journalists this week that infants who are breast fed have a higher HIV transmission rate but a lower mortality rate at 7 months than infants who are not breast fed. On the other hand, infants who are on formula milk have a higher mortality rate and lower infection rate. Both feeding strategies had comparable HIV-free survival at 18 months.
The risks of not breast feeding were critically exposed when flooding in early 2006 contaminated water supplies in the country and led to thousands of diarrhea cases and hundreds of deaths.
The case revealed just how vulnerable children who are not breast fed are in areas that do not have access to clean running water.
Subsequent investigations by the Centers for Disease Classification (CDC) found that infants who were not breast fed were 50 times more likely to be admitted for diarrhea.
Dr Makhema says formula feeding should be used only because of medical conditions and even then other factors would have to be taken into consideration.