HIV-infected mothers may breast-feed

PATRICIA MAGANU
Staff Writer | Thursday November 18, 2010 00:00

Ministry of Health (MOH) and BOTUSA, about two years ago, announced that breast-feeding for HIV positive mothers is not a bad idea at all as research had showed that it was 96 percent safe.

In an interview, Dr Tebogo Madidimalo, who is the PMTCT National Program in the Ministry of Health, said the numbers of HIV-infected breast-feeding women still remain low, while those on  formula feeding are still high.

Madidimalo said that it is true that HIV-infected women can opt to breastfeed in accordance with the policy. 'In the context of low breast-feeding rates among the general population in the country, regardless of HIV status, it naturally follows that majority of HIV infected mothers would opt to breastfeed,' he said.

He said that there has not been much of a shift in the numbers in recent years.  'It is still in question where the weighted influence on formula feeding as an option for HIV-infected mothers is as per national practice, or from weighted counselling by service providers. These are some of the questions the program is currently seeking answers to,' he stated. 

Madidimalo said the end decision lies with the mother as she is the one who makes the feeding choice for their child following counselling, and the government supports them on the choice they have made. He further said that a large number of women enrol in the PMTCT programme in both urban centres and in rural areas.

'According to our programme reports, more women are willing to participate in the programme compared to when the programme started. As per our latest reports, more than 95 percent of pregnant women enrol into the programme with best outcomes,' said Madidimalo.  She further said that though the PMTCT programme has done wonders in the country it is difficult to have zero babies born without HIV.

'Botswana is a high prevalence country, and generalised epidemiology of the HIV/AIDS. That in itself, make it difficult to have 0 (zero) babies born without HIV/AIDS. The programme interventions have succeeded in reducing the transmission rate from mother to child from around 40% without interventions, to <4% with interventions,' he said.  Madidimalo further stressed that it should be understood that not all mothers who test positive enrol into the programmes due to a plethora of reasons, ranging from socio-cultural to outright non-engaging into government provided services.  As far as access to the PMTCT program is concerned Madidimalo says that Botswana is the envy to many countries around the world when it comes to access to healthcare services.

'This has made PMTCT services accessible at all levels, from Referral hospitals, to district hospitals, to clinics, health-posts and even mobile-health stops conducted by midwives and other healthcare workers in hard to reach areas'.

Madidimalo says that at the moment when a mother has an HIV positive baby because they did not join the PMTCT program there is not much that can be done.  'It should be noted that it is not within the scope of the PMTCT programme to come up with the punitive measures for mothers whose babies turnout to be HIV-infected,' he said.  He added that currently the practice is to ensure that the HIV-infected pregnant mother is continually counselled throughout pregnancy about the importance of enrolling into the programme to reduce the risk of transmission to the baby.  'HIV-exposed babies are also enrolled into the programme, given prophylactic treatment, and tested at six weeks and 18 months to ensure that they are not infected. Any infant who tests positive at any stage, is enrolled into Anti-Retro Viral (ARV) programme and started on Highly Active Anti Retro Viral Treatment (HAART),' said Madidimalo.