Breastfeeding or Formula Feeding when HIV-positive: You Decide. 

AllLife outlines an important choice for HIV-positive parents: breastfeeding or formula – you decide. HIV-positive mothers are often faced with the difficult decision of choosing between breastfeeding or formula feeding their babies.

Can HIV be transmitted through breastfeeding? 

HIV can be transmitted through breast milk and may increase the risk of perinatal HIV infection. 

HIV-positive mothers and breastfeeding

In resource-limited locations, such as South Africa, the World Health Organisation (WHO) proposes that mothers living with HIV should breastfeed exclusively for the first six months. Mothers living with HIV should then continue breastfeeding for at least twelve months, including supplemental foods from the second half. The mother’s health should be maintained with ART (Antiretroviral Treatment) adherence to decrease risk of transmission through breastfeeding, and in doing so, support the mother’s health.

HIV-positive mothers and Anti-Retroviral Treatment 

Maternal Anti-Retroviral Treatment (ART) can significantly reduce the risk of transmission through breast milk, but it does not exclude the risk of infection. 

HIV-positive mothers and formula feeding

An HIV-positive mother can breastfeed and formula feed simultaneously, but only under the supervision of their healthcare workers. The healthcare worker will reassure you that ART reduces the risk of postnatal HIV transmission even when the baby is on mixed feeding. 

HIV-positive mothers and mixed feeding


Mixed feeding may affect a good supply of breastmilk. It is important to discuss options when considering supplementing with formula with your clinic, health nurse, lactation consultant or doctor. 

Being diagnosed with HIV

I was fortunate enough to have had both my children well before being diagnosed HIV positive. My personal choice at the time was to breastfeed. I did for thirteen and eighteen months, respectively.

Breastfeeding:

  • Breast milk comprises the correct percentage of nutrients your baby needs, including protein, carbohydrates, fat, and calcium.
  • Breast milk offers natural antibodies that help your baby fight illnesses.
  • Breastfeeding may increase your child’s intelligence. 
  • Breast milk is always available and is free. That said, breastfeeding takes time and energy, and breastfeeding mothers need to be well supported by their partners, family, and medical professionals throughout their breastfeeding journey. 

Formula:

  • Formula feeding is convenient. 
  • Formula feeding  is flexible. 
  • Scheduling formula feedings may be easier.
  • Breastfeeding mothers do not have to worry about what they eat. At times, breastfeeding mothers need to avoid certain foods.

Ultimately it is the parent’s choice and preference as there are benefits to both options. You decide what will work best for you with the guidance of your healthcare worker.

For more on HIV breastfeeding, read HIV/AIDS: Infant feeding and nutrition (who.int)

A chronic condition can affect anyone. How you manage it is what makes the difference. For more support and guidance on living with HIV, contact AllLife.