I breastfeed my babies despite being HIV positive

Prior research shows that exclusive breastfeeding in the first six months of an infant’s life is associated with a three- to fourfold decreased risk of HIV transmission compared to infants who were breastfed and also receive other milks or foods. COURTESY PHOTO

What you need to know:

Prior research shows that exclusive breastfeeding in the first six months of an infant’s life is associated with a three- to fourfold decreased risk of HIV transmission compared to infants who were breastfed and also receive other milks or foods.

There are many disheartening discoveries that we make in life, but for 32 year-old Samalie Nabitaka, a resident of Namayiba in Mukono District, that was discovering that she had HIV. Worse still is that she does not know how she contracted the virus.

“I surely cannot tell how it happened because I was okay by the time I got married. I only discovered in 2012, when I was four months pregnant during an antenatal visit at Mukono Health Centre IV,” she recalls, adding, “Though undeniably shocked, I was helped and subsequently started taking ARVs throughout the pregnancy.” The tone with which she speaks portrays a brave woman who has accepted the fate and decided to live happily with her family regardless of her status.

At the time of our meeting, she had brought her second child to hospital for a third blood test.
This mother of two girls (six years and one-and-half-years) does not, by any account look sick and only her story will justify what I had earlier learned.

Revelation
Opening up to her husband about her condition was like delivering news of the death of a relative. She is thankful that with time, he agreed to go for tests and start on ARVs as the results had turned out positive. Counselling was of great importance during Nabitaka’s first preganancy and as soon as she got labour pains, she was rushed to hospital as the midwife had advised her. “I had been cautioned about the dangers of delivering from home and also urged to open up about my status to the attendant the moment I reached the hospital,” she shares.

She gave birth to her first child on May 8, 2012 at 9am, and given her status, Nabitaka received extra care during delivery in a bid to save the child from contracting the virus at birth.
She was accorded the same care during the delivery of her second child in February 2017. And because of that, they are both HIV negative.

Breastfeeding
Just as it is with other mothers, Nabitaka breastfed her babies right after delivery. “The babies were given a nevirapine syrup from day one for six weeks and later introduced to a septrin syrup that I administered until each made a year,” she adds.

Nabitaka, who has been married for eight years says she always feeds well during pregnancy and after delivery as this helps her get enough breast milk for the baby and stay strong.

“I have exclusively breastfed my children for six months and stop at exactly one year as long as the tests confirm that the child is negative, as advised by doctors,” she mentions, “I have also made sure that I take them to hospital for check-ups thrice; at one and a half months, one year and the other at one and half years and give them the medicine as prescribed by the doctors.” Breastfeeding stops at one year because at this time, they are developing teeth and can bite, causing wounds on the breasts which is not good. However, complimentary feeding starts at six months, just like for any other baby. Nabitaka is also very cautious to continuously check her breasts before breastfeeding. In case the breasts have a wound, crack or soar, doctors advised her not to breastfeed the baby. This was in a bid to avoid transmitting the virus to the child.

She adds that doctors not only talked about cracked or wounded breasts as being dangerous but also mentioned that if the baby has wounds in the mouth, breastfeeding them would predispose them to acquiring HIV.
“I have also been cautioned not to use the same sharp instruments such as razor blades that we use on the children,” she explains, “I keep ours separate from theirs to avoid infecting them.”

Nabitaka was also advised not to serve the children with bare hands when she gets wounds on her fingers or hands. “In case of a wound, I use a spoon to feed my babies rather than bottles because I believe I cannot get time to wash them thoroughly,” she explains.
She has continued to feed her children on a balanced diet as well herself; they never miss vegetables and fruits every day. So unlike other HIV positive people who fail to eat because of anxiety; Nabitaka is stress free and eats well.

Presently
“Although my husband and I are still on medication, our children are off and free from the virus. I have only been cautioned to feed them well and make sure I do not expose them to anything that might cause them to contract the virus,” she explains.
Her six-year-old first born is already in school. “My child is so bright and is always among the best five performers. I will continue to take care of them and we are now planning to secure a plot of land, build a home where we can groom our children,” she discloses.

Nabitaka advises her fellow HIV positive mothers to not only breastfeed their children and avoid infecting them. She also urges them to be hopeful, take their medication in time and eat well to live longer.
Nabitaka and her husband operate a retail shop but she never leaves her children in the hands of other people, she normally creates space in the shop where they can be.

Weaning
It is possible for HIV positive mothers to have HIV negative children, and they can also breastfeed them exclusively for six months as normal mothers do. Unlike negative mothers who breastfeed for two years, an HIV positive mother has to wean the baby at exactly one year.

However, taking care of a pregnant HIV positive mother starts during her antenatal visits where they are encouraged to take ARVs. They are usually given hospital appointments where doctors check on their progress. They are then given prior training of what they have to do during and after delivery.

At delivery, mothers have to come to hospital for proper care during delivery. After delivery, we initiate the babies on a nevirapine syrup that is administered for six weeks.

Mothers have to bring their babies to hospital after six weeks for the first check-up, where the baby stops taking the nevirapine and is introduced to septrine syrup. All this is to guard against the virus since it in the mother’s breast milk.
Mothers are advised to exclusively breastfeed for the first six months as introducing other foods at this time might create wounds in their mouth, making them prone to HIV.

At six months, the baby is introduced to complementary feeding and the second blood test is conducted to ascertain the baby’s status. When negative, they continue taking the septrine syrup unti one year as they breastfeed and have complementary feeds.

At nine months, another test is conducted and if it confirms that the baby is negative, they are taken off the syrup and at one year, the mother is advised to cease breastfeeding and another, six weeks after weaning.

At one and a half years, a confirmation test is conducted, if it comes out positive, they baby is initiated on ART drugs (ARVs for babies). However, mixed feed should be avoided least the baby’s gums are damaged making them prone to infection.
Sharifah Nakiwala, midwife at Mukono health centre IV