Breastfeeding in infants born to HIV positive mothers: position of Pediatric HIV/AIDS Committee of Chilean Society of Pediatrics

Abstract

Breastfeeding is the ideal way to feed infants; however, in the context of human immunodeficiency virus (HIV) infection, it is a potential route for postnatal transmission. Even in women with sustained viral suppression, a residual risk of vertical transmission through breast milk persists, which increases in certain circumstances. In high-income countries, supervised support schemes have been developed with strict virological control for women who opt to breastfeed; these require multidisciplinary teams, rigorous clinical and laboratory monitoring, and prompt access to healthcare. In Chile, the current epidemiological situation, characterized by a high proportion of migrant pregnant women, socio-cultural and linguistic barriers, centralized diagnosis, and limitations in human and laboratory resources, poses significant challenges to the safe implementation of these models. Based on the available evidence and the national context, the Pediatric HIV/AIDS Committee of the Chilean Pediatric Society reiterates that formula feeding is the safest method for preventing postnatal vertical transmission and does not endorse universal breastfeeding for children of mothers living with HIV. Instead, they advocate an individualized approach in specific situations.