Mother-to-child transmission of HIV can occur during pregnancy, at the time of delivery, or through breastfeeding. Breastfeeding is responsible for 40% of mother-to-child transmission cases, and as a result approximately 200,000 babies acquire HIV every year through breastfeeding [1].

 

The WHO policy states that, "when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended [2]." However, the use of replacement feeding (formula) in low-resource settings has been shown to increase infant mortality due to diarrhea and malnutrition, even given the risk of HIV infection. As a result, most mothers are left with only one option-breastfeed and risk transmission of the virus. Our work is focused on eliminating this risk.

Nipple shields are worn by mothers when there are difficulties in breastfeeding. Our approach is to adapt a nipple shield to deliver compounds during feeding that prevent infection. In particular, our modified nipple shield could deliver antiretroviral drugs to the infant for prophylaxis against infection or release an edible microbicide into breast milk that directly reduces HIV infectivity in the milk. Other potential applications include nutritional supplement and pediatric medicine delivery. This project has been supported by a Gates Foundation grant, and is a collaboration of several organizations, university teams, and individuals.

 

1: Chasela C.S., Hudgens M.G., Jamieson D.J., et al. (2010) Maternal or infant antiretroviral drugs to reduce HIV-1 transmission. New England Journal of Medicine 362:2271-81.

 

2: WHO, UNAIDS, UNFPA, UNICEF. (2010) Guidelines on HIV and infant feeding. http://whqlibdoc.who.int/publications/2010/9789241599535_eng.pdf