Successful implementation of new Swiss recommendations on breastfeeding of infants born to women living with HIV. (April 2023)

• Record Type: Journal Article
• Authors: Crisinel, Pierre Alex; Kusejko, Katharina; Kahlert, Christian R; Wagner, Noémie; Beyer, Leila Sultan; De Tejada, Begoña Martinez; Hösli, Irene; Vasconcelos, Malte Kohns; Baumann, Marc; Darling, Katharine; Duppenthaler, Andrea; Rauch, Andri; Paioni, Paolo; Aebi-Popp, Karoline
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 283(2023)
• Page Start: 86
• Page End: 89
• Publication Date: 2023-04
• Subjects: cART combination antiretroviral therapy -- pVL plasma viral load -- SHCS Swiss HIV Cohort Study -- MoCHiV Swiss Mother and Child HIV Cohort Study -- CI confidence interval -- IQR interquartile range; HIV -- Women living with HIV -- Breastfeeding -- Swiss Mother and Child HIV Cohort Study -- Switzerland; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2023.02.013
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Introduction: Swiss national recommendations advise, since end of 2018, supporting women with HIV who wish to breastfeed. Our objective is to describe the motivational factors and the outcome of these women and of their infants. Methods: mothers included in MoCHiV with a delivery between January 2019 and February 2021 who fulfilled the criteria of the "optimal scenario" (adherence to cART, regular clinical care, and suppressed HIV plasma viral load (pVL) of <50 RNA copies/ml) and who decided to breastfeed after a shared decision-making process, were approached to participate in this nested study and asked to fill-in a questionnaire exploring the main motivating factors for breastfeeding. Results: Between January 9, 2019 and February 7, 2021, 41 women gave birth, and 25 decided to breastfeed of which 20 accepted to participate in the nested study. The three main motivational factors of these women were bonding, neonatal and maternal health benefits. They breastfed for a median duration of 6.3 months (range 0.7–25.7, IQR 2.5–11.1). None of the breastfed neonates received HIV post-exposure prophylaxis. There was no HIV transmission: 24 infants tested negative for HIV at least 3 months after weaning; one mother was still breastfeeding when we analyzed the data. Conclusions: As a result of a shared decision-making process, a high proportion of mothers expressed a desire to breastfeed. No breastfed infant acquired HIV. The surveillance of breastfeeding mother-infant pairs in high resource settings should be continued to help update guidelines and recommendations.