Wet nursing increases risk of HIV infection among babies

BMJ 2005; 330 doi: (Published 14 April 2005) Cite this as: BMJ 2005;330:862
  1. Pat Sidley
  1. Johannesburg

    South African children using public hospitals are exposed to HIV infection because of a lack of infection control and because some babies are breast fed by women who are not their mothers and who are HIV positive, a new study says.

    The study was conducted by the country's Human Sciences Research Council, Medical Research Council, and others for the Nelson Mandela Foundation.

    It was commissioned after a previous study by the same group in 2002 found an unusually high proportion of children between the ages of 2 and 9 years infected with HIV. The suspicion had been voiced at the time that infection during these years may have been caused by particularly high rates of sexual abuse of children in South Africa. However, the study's authors, Dr Olive Shisana and colleagues, say that for ethical and legal reasons they did not look into the possibility of sexual abuse among the children in the study. They have instead concentrated on the possibility that HIV infection was contracted in hospitals.

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    A South African child with AIDS is comforted by a child psychologist. Some children with AIDS have contracted HIV through wet nursing


    The study was conducted at several public hospitals in the Free State province and looked at dental facilities, maternity wards, and paediatric wards. In all these settings the researchers found that HIV could potentially be contracted.

    Nearly 30% of the milk to be fed to babies tested positive for HIV viral RNA. Almost half (47%) of the instruments to be used clinically on children and a quarter of instruments to be used in children's mouths and gums had traces of blood on them.

    The new finding of wet nursing as a mode of HIV transmission in South Africa followed from the finding that 1.7% of children in the study were breast fed by women who weren't their mothers. HIV positive children were 17 times more likely than HIV negative children to have been breast fed by a woman other than their mother.

    HIV Risk Exposure in Children Aged 2-9 Years Served by Public Health Facilities in the Free State, South Africa is available at

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