A HIV positive mother can breastfeed her newborn baby. This statement is?

NHM MP Staff Nurse-2019

Obstetrics & Gynaecology

Medium

Appeared in: NHM MP Staff Nurse-2019

Explanation

Antiretroviral Therapy (ART) effectively suppresses the HIV viral load in the mother's body fluids, including breast milk.
With a sustained, undetectable viral load, the risk of transmitting HIV to the infant through breastfeeding is extremely low (less than 1%).
Global (WHO) and national (NACO) health guidelines recommend exclusive breastfeeding for the first 6 months for HIV-positive mothers on ART due to the significant health benefits for the infant, which outweigh the minimal transmission risk.
The infant should also receive antiretroviral prophylaxis (e.g., Nevirapine) for a specified period after birth as an added layer of protection.

Option B: This is the opposite of current guidelines. ART is the key intervention that makes breastfeeding safe for HIV-positive mothers.
Option C: This describes mixed feeding, which is contraindicated. Introducing other foods or liquids alongside breast milk can cause gut inflammation in the infant, which damages the intestinal lining and increases the risk of HIV transmission.
Option D: The decision is entirely dependent on the mother's ART status. ART adherence and achieving viral suppression are the cornerstones of preventing mother-to-child transmission.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of Mother-to-Child Transmission (PMTCT) of HIV and infant feeding guidelines as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to provide accurate, non-judgmental counseling to HIV-positive mothers about infant feeding options, based on the latest guidelines.
Nurses must emphasize the importance of strict adherence to ART for the mother's own health and to keep the baby safe during breastfeeding.
Nurses are responsible for teaching the mother about exclusive breastfeeding, monitoring for any issues like mastitis (which can increase transmission risk), and ensuring the infant receives their ARV prophylaxis correctly.

How to Approach the Question

First, identify the core of the question: it's about the safety of breastfeeding by an HIV-positive mother.
Recall the fundamental principle of modern HIV care: Antiretroviral Therapy (ART) suppresses the virus.
Consider how ART would affect transmission through breast milk. Logically, if the virus is suppressed, the risk of transmission should be lower.
Evaluate the options based on this principle. 'True if on ART' aligns with the effectiveness of the treatment.
Eliminate 'False if on ART' as it contradicts the purpose of ART.
Eliminate 'Along with top feed' by recalling that mixed feeding is known to be risky in this context.

Concept Tested & Keywords

Concept Tested: Prevention of Mother-to-Child Transmission (PMTCT) of HIV and infant feeding guidelines.
Stem keywords: HIV positive mother, breastfeed, newborn baby
Lead-in keywords: This statement is
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 2121-2123, 2096-2098

E6 Medicine Harrison 22e Part 1 p. 1606-1608