'Mma Bana' scores breakthrough for breastfeeding

MARANYANE NGWANAAMOTHO
Staff Writer | Friday June 18, 2010 00:00

The study found that HIV-infected mothers who take combinations of ARVs can safely breastfeed.  The study has shown that 99 percent of HIV infected women who enrolled for highly active antiretroviral therapy (HAART) during pregnancy and breastfeeding are less likely to transmit the virus to their babies.

Project director, Dr. Joseph Makhema, says the study was the first randomised study in Africa to compare HAART regimens used during pregnancy or breastfeeding, producing the lowest rate of mother to child transmission in comparison with other studies done in Africa.

The study compared suppression of the mother's HIV at delivery and throughout breastfeeding among the women assigned to receive one of the treatment therapies.

Makhema says almost all women achieved viral suppression by delivery, and that their virus remained undetectable throughout breastfeeding.  'Pregnant mothers are given treatment at 28 weeks of pregnancy.

Mothers who do not require treatment - that is those with a CD4 count that is more than 200 - will take treatment but stop it after delivery. 'Those who take treatment for their own health benefit - that is, those with CD4 count that is less than 200 - take treatment and continue with it even after delivery,' he said.

Makhema says the Mma Bana study has influenced WHO guidelines on the use of HAART to prevent mother to child transmission.  'For the first time, WHO recently recommended that all HIV infected mothers or their infants take antiretroviral drugs while breastfeeding to prevent HIV transmission.  The Botswana government is preparing to roll out a program to provide HAART to all pregnant women with HIV,' Makhema reported.

Makhema says the problem with the current protocol is that babies were exposed to illnesses as a result of bottle-feeding.  'Currently, the protocol has been that women on treatment could not breastfeed their babies while the babies had to take one month treatment while feeding on formula.  'This exposes children to illnesses as the formula is not always prepared well or the bottles got exposed to infections,' says Makhema.

The method was not sustainable because the formula would sometimes run out leaving mothers and babies in a desperate situation.   'It was therefore necessary to find a method that would be affordable and sustainable to control transmission of the virus from mothers to babies,' concluded Makhema.