The researchers say little is known about predictors of breast problems in HIV-infected women. They do know, however, that nearly half of HIV-infected mothers don't receive antiretroviral drugs. And the risk that they'll pass the virus to their infants is increased if they have mastitis or a breast abscess, said lead investigator Dr Katherine Semrau
Dr Semrau of Boston University School of Public Health and colleagues studied 947 HIV-positive mothers in Zambia, following them until a month after they had stopped breastfeeding, or six months postpartum, or death.
After adjusting for factors including the child's age and maternal CD4 count, women who were practising mixed feeding or who had stopped breastfeeding were nearly twice as likely to have a breast complication, compared to those who were exclusively breastfeeding. They were 2.87 times as likely to have mastitis.
Exclusive breastfeeding did not appear to protect against breast abscess, however, according to an online paper in the American Journal of Obstetrics and Gynecology.
Educate women about breastfeeding
Women with CD4 counts below 200 cells/uL were more than twice as likely to have an abscess compared to women with CD4 counts above 350, but the difference was not significant.
Programmes supporting exclusive breastfeeding, say the investigators, significantly reduce rates of breast pathologies in HIV-infected women.
"Focusing on education of the HIV-infected mother with respect to breastfeeding pattern," they conclude, "may also prevent transmission by reducing two important risk factors, namely mastitis and breast complications, and improve the health of the mother by reducing breast problems."
Dr Semrau added, "This study highlights the importance of exclusive breastfeeding as non-exclusive breastfeeding increased risk of breast problems. For clinical practise, it is important to encourage women to exclusively breastfeed for two reasons, namely:
1. For her own health to prevent breast problems
2. To prevent transmission of HIV to her breastfeeding child.
(Reuters Health, David Douglas, July 2011)