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PEDIATRICS Vol. 112 No. 5 November 2003, pp. 1196-1205

TECHNICAL REPORT

Human Milk, Breastfeeding, and Transmission of Human Immunodeficiency Virus Type 1 in the United States

ABSTRACT

Transmission of human immunodeficiency virus type 1 (HIV-1) through breastfeeding has been conclusively demonstrated. The risk of such transmission has been quantified, the timing has been clarified, and certain risk factors for breastfeeding transmission have been identified. In areas where infant formula is accessible, affordable, safe, and sustainable, avoidance of breastfeeding has represented one of the main components of mother-to-child HIV-1 transmission prevention efforts for many years. In areas where affordable and safe alternatives to breastfeeding may not be available, interventions to prevent breastfeeding transmission are being investigated. Complete avoidance of breastfeeding by HIV-1-infected women has been recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention and remains the only means by which prevention of breastfeeding transmission of HIV-1 can be absolutely ensured. This technical report summarizes the information available regarding breastfeeding transmission of HIV-1.

Abbreviations: HIV-1, human immunodeficiency virus type 1 • CDC, Centers for Disease Control and Prevention • AAP, American Academy of Pediatrics • CI, confidence interval • WHO, World Health Organization • UNICEF, United Nations Children’s Fund • UNAIDS, the Joint United Nations Program on HIV/AIDS • OR, odds ratio • RR, relative risk • SLPI, secretory leukocyte protease inhibitor

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