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Can You Breastfeed if You Have HIV?

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Can You Breastfeed if You Have HIV?

Baby formula is recommended for moms living with HIV in the U.S. because of a slim chance that babies may contract HIV through breast milk.

Women living with HIV who take antiretroviral therapy and have undetectable viral loads may give birth to HIV-free babies. They may see “breast is best” posters in their doctors’ offices and wish to breastfeed their babies. But they may not think that it’s an option for them.

“Everyone knows there are numerous health benefits from breastfeeding, even compared to formula feeding,” says Patrick Jean-Philippe, MD. He’s the chief of the maternal, adolescent and pediatric research branch in the AIDS division of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases.

But for women living with HIV, Jean-Philippe says, ”this is where the benefits of breastfeeding versus the risk of transmission may become a little bit in the gray zone.”

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What Is the Risk of HIV Transmission From Breastfeeding?

An NIH-funded study conducted in six African nations (South Africa, Malawi, Tanzania, Uganda, Zambia, and Zimbabwe) and India tracked the risk of a baby getting HIV from breastfeeding. The researchers found that when women with HIV took antiretroviral therapy while breastfeeding, it nearly eliminated the risk of HIV transmission. Less than 1% of babies – specifically, 0.6% – who were breastfed for a year contracted HIV through breast milk.

But the transmission rate isn’t zero. So breastfeeding isn’t recommended in the U.S for women with HIV.

The CDC’s website states that this recommendation has been in place since 1985 and “remains consistent with the most up-to-date scientific literature and is considered best practices for preventing HIV transmission.”

In 2021, a panel of experts made a slightly more nuanced recommendation to the U.S. Department of Health and Human Services. The panel states that breastfeeding isn’t recommended for people with HIV – but that if someone with HIV decides to breastfeed, their doctor should provide patient-centered, evidence-based counseling on infant feeding options to help minimize the risk of HIV transmission.

In its report, the panel made clear, in bold print, that this part of their recommendations “is not intended to be an endorsement of breastfeeding, nor to imply that breastfeeding is recommended for individuals with HIV in the United States.” HHS has not adopted the panel’s recommendations yet.

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When a Mom With HIV Wants to Breastfeed

“Choosing to breast/chest feed is a reasonable choice and, in fact, the optimal choice for some families,” says Deborah Cohan, MD, MPH, professor of obstetrics, gynecology, and reproductive sciences at UCSF and medical director for HIVE at San Francisco General Hospital, which provides prenatal care to women living with HIV. “While we as providers may have our own bias and discomfort, we need to support our patients making choices for themselves.”

“There is this ongoing concern that … someone could face criminalization issues, and that’s really going to impact Black women and other women of color more than white women,” says Krista Martel, executive director of The Well Project, a nonprofit organization that supports women living with HIV who want to breastfeed.

Martel and Cohan say there are even anecdotal reports that some doctors may call Child Protective Services out of concern about the risk.

Some women with HIV look for doctors who support their choice to breastfeed – whether it’s something they want to do or if they’re having trouble finding formula feeding products during the current shortage.

New parents and their doctors can discuss the risks and benefits. “With shared decision-making, they can [ensure] that the woman is at the lowest risk,” Jean-Philippe says.

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Meds Matter

People with HIV who breastfeed must continue taking antiretroviral therapy to treat their HIV. They should visit the doctor monthly to confirm that their viral load is still suppressed.

“This is optimal for their health too, not just related to preventing HIV transmission to their baby,” Cohan says. She says they try to engage pregnant patients about what will help with that so that they’re ready when the “sleepless nights and all the ups-and-downs of being postpartum” kick in.

Women should feel confident that taking antiretroviral medication is safe if they are breastfeeding. Some doctors also prescribe medication for babies, to lower the risk of transmission.

“Generally, we think antiretrovirals taken by the pregnant and lactating person is safe for the babies,” Cohan says. “Almost all antiretrovirals studied so far are associated with low levels in the infant blood when ingested via the milk. There are no antiretrovirals that appear to be specifically unsafe for babies via milk.”

One Mom’s Story

Ciarra “Ci Ci” Covin of Philadelphia, a woman living with HIV, became pregnant in 2010. She says that she was told that she couldn’t breastfeed her baby. So she used formula. When Covin became pregnant again in 2021, she took a different approach. Covin was on staff with the Well Project and says she had spoken with many doctors who supported breastfeeding among women living with HIV. That gave her confidence to find new doctors who would support her choice to breastfeed.

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“The infectious disease [specialist], OB/GYN, and pediatrician — they were all on the same board that was allowing for shared, informed decision-making,” Covin says. “I was willing to take that [less than 1% transmission] risk.”

While Covin breastfed her daughter, the baby received medication to reduce the risk of transmission. Covin’s daughter is HIV-free, and Covin is thankful for the experience.

“I had to reframe my thinking” about doctors, Covin says. “I have goals and quality of life, [and] I just need you to support me.”

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How to Feel Hopeful, Even When It’s Really, Really Hard

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How to Feel Hopeful, Even When It’s Really, Really Hard

And for those with mental illnesses, such as depression or anxiety, cultivating hope and resilience can be key to managing their symptoms, Dr. Tedeschi says. In depression, for instance, a persistent feeling of hopelessness is often a defining symptom. In the case of anxiety, fear is one of the driving factors. “In both cases, they’re drawing the conclusion that things are out of their control and things aren’t going to work,” Dr. Tedeschi says. Figuring out a way to become more hopeful, even—or especially—when life is difficult, is usually a necessary component of treatment.

Being hopeful can help you build resilience.

Putting in the work to be hopeful has other psychological benefits too. In particular, hope helps build resilience, which “is the ability to either recover quickly from events that are challenging, or traumatic, or a crisis or to be relatively unaffected by these events,” Dr. Tedeschi explains.

But resilience isn’t just being able to withstand a difficult situation. “It has to do with living a fuller life,” Lillian Comas-Diaz, PhD, a psychologist specializing in trauma recovery and multicultural issues, tells SELF. “Resilience is a way of coping with adversity and being able to get some knowledge from that adversity,” which might help you improve your coping mechanisms for the future.

From there, it’s easy to see how hope, optimism, and a generally more positive outlook might develop with resilience. It works like a feedback loop, Dr. Tedeschi says: “If you have success in managing these situations, you become more optimistic about how you’re going to do in the future,” he explains. And as you develop some optimism and hope, that might help you persist and manage in the face of the difficulties we all inevitably face.

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How to be hopeful when things feel hopeless

Here are a few tips from our experts:

If it’s really hard to feel hopeful right now, start by just acknowledging that.

Some people are just naturally optimistic, even in a situation like this. But, generally, resilience is something that’s learned—first through our experiences in childhood, potentially, and then later as we go through the inevitable challenges of life, Dr. Tedeschi says. So for those of us who maybe feel a little silly trying to look for a silver lining in, you know, these Unprecedented Times, trying to be hopeful just doesn’t feel genuine. And if it’s not authentic, it isn’t very helpful.

If you’re someone who finds it difficult or even feels silly trying to be optimistic right now, know that hope doesn’t necessarily mean thinking that everything will always be amazing. Being hopeful doesn’t have to be about looking for the bright side or deluding ourselves into thinking everything will be just fine, Dr. Comas-Diaz says. Hope is really just a (realistic) expectation that something good will happen—and that you have some control over it.

For some people, it might be difficult to be hopeful because they don’t have a source of hope they can immediately point to, Dr. Comas-Diaz says. In those cases, she will ask her patients to do an inventory, asking what sources of hope their friends, family, or larger culture draw upon and if the patient can “borrow” from that source as well. Think about, say, your mom or a close friend—what brings them hope? Can you share that with them or get some hope vicariously through them? Or is there a particular cause you’re really passionate about that you can draw some sense of optimism from?

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Gelato recalled in Ontario after testing find norovirus contamination of raspberries

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Gelato recalled in Ontario after testing find norovirus contamination of raspberries

Angelo’s Italian Market Inc. is recalling Gelato Artigianale al gusto di Raspberry Gelatois from the marketplace because of possible norovirus contamination of the raspberries used in this product.

This recall was triggered by Canadian Food Inspection Agency test results.

The recalled product has been sold at Angelo’s Italian Market Inc. in London, Ontario.

Recalled product:

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Brand Product Size UPC Codes
None Gelato Artigianale al gusto di Raspberry Gelato 1 L 0 000000 067430 None – Sold at Angelo’s Italian Market Inc., 755 Wonderland Road North, London, ON up to and including June 14, 2022

As of the posting of this recall, there have been no reported illnesses associated with the consumption of this product.

Recalled products should be thrown out or returned to the location where they were purchased

About norovirus infections

People with norovirus illness usually develop symptoms of gastroenteritis within 24 to 48 hours, but symptoms can start as early as 12 hours after exposure. The virus can live on surfaces for long periods of time and survives freezing temperatures. It is highly contagious.

The illness often begins suddenly. Even after having the illness, you can still become reinfected by norovirus. The main symptoms of norovirus illness are diarrhea, vomiting (children usually experience more vomiting than adults), nausea, and stomach cramps.

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Other symptoms may include low-grade fever, headache, chills, muscle aches, and fatigue (a general sense of tiredness). Most people feel better within one or two days, with symptoms resolving on their own, and experience no long-term health effects.

As with any illness-causing diarrhea or vomiting, people who are ill should drink plenty of liquids to replace lost body fluids and prevent dehydration. In severe cases, patients may need to be hospitalized and given fluids intravenously.

(To sign up for a free subscription to Food Safety News, click here.)

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10 Luxe Mattresses You Can Get Right on Amazon

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10 Luxe Mattresses You Can Get Right on Amazon

It should come as no surprise that Amazon, retail behemoth that it is, has a fantastic range of bedding available—in fact, some of the best mattresses on Amazon come from high-quality brands like Casper, Nectar, and Tuft & Needle. In other words, while you’re perusing early Amazon Prime Day deals on vacuums, furniture, outdoor gear, and wellness products, you can pick up a new mattress for yourself too—how’s that for one-stop shopping? Before you get to scrolling, here’s a quick rundown on what mattress type might suit your sleeping style and give you the best sleep you can get.

Mattresses for Side Sleepers

You should look for a medium-firm mattress that will prevent pressure points from building around your shoulders, hips, and knees (which can lead to back pain). All-foam or hybrid innerspring mattresses will work for you, as long as they provide contouring and support.

Mattresses for Stomach and Back Sleepers

These might be opposite sleep positions, but stomach sleepers can benefit from the same type of mattress as back sleepers: A firm bed that won’t let your lower back arch out of alignment. Again, a memory foam mattress can fit the bill as well as a hybrid mattress, but bear in mind that foam mattresses tend to be on the softer side (making uncomfortable sinkage a risk).

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Overall you want to find a mattress that provides pressure relief and, most of all, nightlong comfort. And Amazon has plenty of options to choose from. From beloved bed-in-a-box mattress brands to best-selling beds at affordable price points, we’ve highlighted our top Amazon mattress picks here. 

All products featured on SELF are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.

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