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According to the latest CDC recommendations, HIV-positive mothers who have questions about breastfeeding or who desire to breastfeed should receive patient-centered, evidence-based counseling on infant feeding options, allowing for shared decision-making. Here's what you should know in order to make your decision. HIV can be spread through certain body fluids, including breast milk. While HIV transmission to infants can occur during pregnancy, birth, or breastfeeding, treatment for HIV substantially reduces the risk of transmission. Although maternal treatment of HIV substantially reduces the risk of transmission through breast milk, it does not eliminate the risk. You should therefore weigh the benefits of breastfeeding against the potential risks of HIV transmission to your infant.

The best way to prevent transmission of HIV to your infant through breast milk is to not breastfeed. In the United States, where mothers have access to clean water and affordable replacement feeding (infant formula), it is recommended that mothers living with HIV completely avoid breastfeeding their infants, regardless of consistent HIV treatment and maternal viral load. Infant formula and pasteurized donor human milk are safe feeding alternatives to breastfeeding for mothers living with HIV. These recommendations differ from those in certain parts of the world, where mothers do not have access to the same infant feeding options. In countries where resources are limited, it is recommended that mothers living with HIV breastfeed exclusively for the first 6 months of life and continue breastfeeding for at least 12 months, with the addition of complementary foods. These mothers should be fully supported with HIV treatment access that reduces the risk of transmission through breastfeeding.

If you choose to breastfeed, you should remain fully committed to taking your HIV treatment to achieve and maintain an undetectable viral load. You should, also, receive close follow-up with your HIV provider to maintain risk-reduction measures that minimize the risk of HIV transmission to your infant.