Does infant feeding modality have an impact on the health of mothers infected with human immunodeficiency virus in sub- Saharan Africa? A systematic literature review

Abstract

Concerns for perinatal HIV transmission and health of infants have led to calls for a religious adoption of WHO recommendations on HIV and infant feeding. That which is not established is how this impacts on the health of mothers. While the dilemma of breastfeeding and risk of transmitting the virus to the infant is fast becoming history, the impact infant feeding choices may have on the health of mothers is not well characterized. This review provides current knowledge on how infant feeding choices of HIV-positive mothers affect their own health. A computer-aided systematic search of literature for articles published between 1985 and 2010 was done. Two independent literature searches were conducted using PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Ten eligible articles, most of which reported no adverse effect of breastfeeding on health of HIV-positive mothers. One study presented findings attributing increased maternal mortality to breastfeeding. Another study concluded that breastfeeding was associated with reduced CD4 counts and lower body mass index, although these effects were not clinically relevant. Several others attributed maternal morbidity and mortality to high levels of plasma HIV viral load. This review does not support the belief that HIV-positive mothers are exposed to an increased risk of adverse conditions when breastfeeding. Key words: Infant feeding modality, sub-Saharan Africa, HIV-positive mothers, breastfeeding, mixed feeding, formula feeding.