Breast Milk: A Tool To Fight HIV?

by Heidi Green
August 02, 2012

Is there anything breastfeeding can’t do?

The health benefits of breastfeeding have been well established by the American Academy of Pediatrics (AAP) and others, but researchers now suggest that breast milk may have a role in fighting HIV.

About 34 million people around the world are currently living with HIV, and nearly as many have died from AIDS-related causes since U.S. health authorities first became aware of the virus more than 30 years ago.

While antiretroviral drugs, when available, temper the effects of the virus and extend one’s life, the pandemic continues to spread. According to one prominent expert in the field suggests, “[f]or every person who starts antiretroviral therapy, two new individuals are infected with HIV”, making the need for tools to fight this virus is enormous. Could something as natural as breast milk be added to the toolbox?

Research
A research team led by Dr. Angela Wahl of the University of North Carolina at Chapel Hill examined the effect of breast milk in neutralizing the HIV virus. The study subjects were classified as “humanized mice,” animals surgically altered with human bone narrow, liver, and thymus tissue, to produce “human” immune systems, making the mice susceptible to HIV in the same way as human beings.

Wahl and colleagues identified four priorities for study:

1. Oral transmission of HIV

2. Transmission orally or within the gastrointestinal tract

3. Role of antiviral medications in preventing oral transmission

4. Role of human breast milk in reducing oral transmission

Results
Previous researchers have found that HIV-positive mothers have a lower risk of infecting their breastfeeding infants when breastfeeding is exclusive during the first six months. However, the mechanism for this protection is unclear.

Wahl and colleagues provide the first clinical confirmation of breast milk’s protective role against HIV, suggesting that an undetermined compound—or compounds—in the milk may destroy the virus and prevent oral transmission from mother to child. Although the researchers fed study mice human breast milk containing HIV, the mice were never infected with the virus.

Whether the compound(s) in breast milk can be identified and used to combat HIV is unknown, but it is an exciting development given the far-reaching nature of this worldwide pandemic. Additional research will compare the breast milk of mothers who transmitted the virus to their infants with milk from HIV-infected mothers who did not transmit the virus to their babies. Researchers will need to account for any possible blood contact, such as might occur in mothers experiencing a bout of mastitis or a cracked nipple.

Recommendations
This research shows, as Dr. Wahl explains in a released statement, “that breast milk is indeed a protective agent” against HIV transmission and “should not be denied even to children of HIV-infected women.” In accord with World Health Organization (WHO) recommendations, HIV-positive mothers and their infants should be given antiretroviral medications, but should be encouraged to breastfeed since “it protects against childhood infections and reduces morbidity and mortality.”

HIV-positive mothers should continue to breastfeed for as long as mother and child desire; one study of more than 700 babies in Zambia found that the sooner a child of an HIV-positive mother was weaned, the greater the child’s risk for dying before the age of 2. For these babies, diarrhea poses a more immediate risk to life than HIV infection.

Although Dr. Wahl’s research is promising, HIV transmission and the role of human milk remains a mystery. Until more information is available, HIV-infected mothers in the U.S. and other developed countries—where safe alternatives to the mother’s own milk are available and an infant’s risk of dying from diarrhea is low—should be advised to follow the recommendations of the Centers for Disease Control and Prevention (CDC) and not breastfeed.