While exclusive breastfeeding is encouraged, some women in Mpumalanga living with HIV claim nurses force them to breastfeed their newborn babies. Many of the women are reluctant to breastfeed because they fear they may pass the virus to their babies.
The Mpumalanga Department of Health says exclusive breastfeeding for the first six months of an infant’s life should be encouraged because breastmilk has enormous benefits. This is in line with international recommendations by the World Health Organisation.
There is unequivocal evidence that exclusive breastfeeding for the first six months and continued breastfeeding afterwards reduces serious illness and mortality, and improves the development of babies.
Breastmilk meets all an infant’s nutritional requirements for the first six months and contains all nutrients in the correct amounts and is easily digested. In addition to protecting against illnesses, it enhances the child’s immune system, reduces allergies and provides long-term protection against diabetes and cancer in adult life.
According to Dumisani Malamule, the spokesperson for the Mpumalanga Department of Health, during antenatal care and while attending maternity services, women should be provided with detailed information on infant feeding, including the risks associated with not breastfeeding. “Equally, the risk of HIV transmission and the importance of antiretroviral treatment adherence should be discussed individually,” he said.
However, he added that if a women decided not to breastfeed her infant after receiving the required counseling, she should be supported in her decision and assisted with information on how to reduce the risks associated with formula feeding - for example, how to correctly constitute a feed, how much formula milk to be given per feed and how often, and how to ensure the feeding equipment is clean and safe.
Ayanda Zwane, 28, said soon after she gave birth the midwife instructed her to breastfeed her son. “I felt that the ‘choice’ was forced on me but other women in the ward said I shouldn’t worry because I can stop breastfeeding him when I get home. I was worried because of my HIV status, which is positive and I was not consistent with my ARVs while I was pregnant. I did as the women suggested, I stopped breastfeeding my child but when I didn’t have formula milk, I breastfed.”
Silindile Masinga from KaBokweni said, “I had to make the right choice for my baby and I refused breastfeeding because I feared it could lead to transmitting HIV to my baby.”
Malamule told OurHealth the most important consideration in the context of HIV is adherence to antiretroviral treatment – for both the mother and the infant.
“With antiretroviral treatment, 98% of infants who are breastfed by HIV-infected mothers for 12 months are unlikely to be infected with HIV – assuming good adherence with antiretroviral treatment,” he said.