Supporting Mothers Living With HIV in the United States Who Choose to Breastfeed
Wei Li Adeline Koay, Natella Rakhmanina
Abstract
To the editor—Yusuf et al [1] reported outcomes of 10 infants exclusively breastfed (median 4.4 months) by virally suppressed women living with HIV (WLHIV) in the United States who remained HIV uninfected. The infants received antiretroviral drug (ARV) prophylaxis with zidovudine (ZDV), lamivudine (3TC), and nevirapine (NVP) for 4 to 6 weeks, followed by NVP alone through 6 weeks after breastfeeding cessation. In response, 2 editorial commentaries raised discussions about the prospects of offering WLHIV in the United States the choice of breastfeeding [2, 3]. Despite recommendations to avoid breastfeeding by WLHIV [4], WLHIV in resource-rich settings express a desire to breastfeed or have breastfed their infants [5, 6]. At an urban HIV clinic at Children’s National Hospital (CNH) in Washington, DC, several WLHIV have chosen to breastfeed their infants. Breastfeeding waivers are not required to avoid additional stigma and...