Breastfeeding: risks and options

The risk of transmitting HIV from mother-to-baby via breast milk can be as high as 28%.

HIV-positive mothers living in industrialised countries can easily avoid this by using bottles and formula milk.

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• Bottle-feeding and free formula milk
• Can I breastfeed occasionally?
• Sometimes people ask me why I do not breastfeed

Bottle-feeding and free formula milk

Bottle-feeding is currently strongly recommended for all HIV-positive mothers. The risk of transmitting HIV from mother to baby via breast milk can be as high as 28%.

After doing all the right things during pregnancy and delivery, you will not want to risk your baby';s health now by breastfeeding.

If you cannot afford the formula, bottles and sterilising equipment can be provided by your hospital so that you do not need to breastfeed. Schemes vary from clinic to clinic.

Your midwife should discuss whether you need this extra support as part of your discharge package when you leave the hospital with your baby.

Medical treatment and provision of formula milk will be in confidence. Please make sure that you take advantage of this if you need to. None of the people who work at the hospital or support workers will have any connection whatsoever with the immigration department.

Can I breastfeed occasionally?

It is very strongly recommended that you do not breastfeed occasionally.

One study showed that 'mixed feeding' may carry an even higher transmission risk than if you breastfeed exclusively.

Sometimes people ask me why I do not breastfeed

Mothers sometimes worry that bottle-feeding will identify them as HIV-positive.

It is up to you whether or not you tell anyone that you are HIV-positive.

If you do not wish to tell anyone that you are not breastfeeding because you are HIV-positive, your doctor or midwife can help you with other reasons to explain why you are bottlefeeding.

For example, you can say you have cracked nipples or that the milk didn't come, both of which are common.

You are not a bad mother if you do not breastfeed.

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This is the web edition of the i-Base guide HIV, pregnancy & women's health. This guide is available in UK clinics. You can order free printed copies or download a PDF version (364 Kb). There are also several translations.

Information on this website is provided as a guide only. All treatment decisions should be taken in consultation with your doctor or other healthcare professional. Authors and credits. Full section index. Glossary.