With breast milk, pathogens can be transmitted and cause the corresponding disease in the children, with different manifestations of the course of the disease. One of the most important pathogens in this context is the human immunodeficiency virus (HIV).
HI viruses and HIV-1-infected lymphocytes can be detected in the mother’s milk. An infection of the baby is additionally promoted by inflammations and injuries of the nipples, through which infectious wound secretion or blood can escape.
If an untreated HIV-positive mother breastfeeds, an estimated 10% of children become infected via breast milk in the first year of life. In countries with good hygiene standards (industrialized countries), these mothers should not breastfeed and the babies should be fed with substitute milk formula.
The situation is different in countries with poor hygiene standards (developing countries). Here, the positive aspects of breastfeeding predominate, so that the WHO (World Health Organization) recommends that mothers breastfeed their children despite HIV infection. Antiretroviral therapy should be started as early as the 14th week of pregnancy and continued until the end of the breastfeeding period. If possible, the baby should be exclusively breastfed for the first six months. The risk of postnatal HIV transmission is lowest in this way. Subsequently, the introduction of complementary foods is started and breastfeeding is continued for at least another 12 months.According to studies, the infection rate is highest with partial breastfeeding. Complete cessation of breastfeeding is also associated with a higher risk of infection in the child than exclusive breastfeeding. This could be due to the oligosaccharides present in breast milk. Furthermore, HIV antibodies have been detected in colostrum (colostrum).
