Department of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Division of Allergy, Immunology, and Retrovirology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Clin Infect Dis. 2023 Feb 8;76(3):535-539. doi: 10.1093/cid/ciac761.
Guidelines in high-income countries generally recommend against breastfeeding for a pregnant person with HIV due to the historical risk of transmission to the infant and generally acceptable, safe, and sustainable access to formula. Maternal antiretroviral therapy and infant prophylaxis have been shown to significantly decrease the risk of transmission during breastfeeding. In addition, formula may not be acceptable to patients for a variety of cultural, social, or personal reasons, and its sustainability is called into question in the setting of the current nationwide formula shortage. Providers caring for pregnant people with HIV have a responsibility to discuss infant feeding with their patients, and help them weigh the risks and benefits within the limits of the current body of evidence. We outline a process, including a written agreement, that can be used to discuss infant feeding with all patients and help them make the best decision for their family.
在高收入国家，由于历史上存在将 HIV 传播给婴儿的风险，以及通常可获得安全且可持续的配方奶，因此普遍不建议 HIV 感染者孕妇进行母乳喂养。抗逆转录病毒疗法和婴儿预防措施已被证明可显著降低母乳喂养期间的传播风险。此外，由于各种文化、社会或个人原因，患者可能无法接受配方奶，而且在当前全国范围内配方奶短缺的情况下，其可持续性也受到质疑。照顾 HIV 感染者孕妇的医务人员有责任与患者讨论婴儿喂养问题，并帮助他们权衡当前证据范围内的风险和收益。我们概述了一个流程，包括书面协议，可用于与所有患者讨论婴儿喂养问题，并帮助他们为自己的家庭做出最佳决策。
