Successful implementation of new Swiss recommendations on breastfeeding of infants born to women living with HIV.  European Journal of Obstetrics & Gynecology and Reproductive Biology.
In the Swiss Mother and Child HIV Cohort Study (MoCHiV), Crisinel et al. investigated the motivational factors for breastfeeding among women with HIV in Switzerland. They also evaluated the transmission risk to infants after the 2018 Swiss recommendation that allowed breastfeeding for women in the “optimal scenario.”
From January 2019 to February 2021, 41 women gave birth, and 25 of them (61%) decided to breastfeed their infants. The median age of these 25 women was 34.8 years (IQR 31.1 – 38.2), with 68% of African origin. The median CD4 cell count at delivery was 649 cells/mcL, and the median gestational age at birth was 39.5 weeks (IQR 39-41). No HIV transmission occurred despite no infant receiving prophylactic ART.
Mothers reported that the most important reasons for breastfeeding were to be in closer contact with their child and because of perceived health benefits for both the child and herself. Notably, 95% of mothers emphasized the importance of interdisciplinary discussions in making their decision.
Taken together, this study shows that breastfeeding is a priority for women with HIV. The findings support the 2018 Swiss recommendation, in which physicians are encouraged to engage in interdisciplinary discussions with pregnant women with HIV to weigh the potential harms and benefits of breastfeeding.