In a quiet moment of reflection, Saudatu Umar (not her real name) gently cradled her newborn baby, her mind filled with doubt and concern. As an HIV-positive mother, each feeding brought with it the constant fear of passing the virus to her child through breastfeeding.
For Saudatu, the journey to this moment was marked by years of uncertainty, a struggle she never anticipated when she discovered her status during a routine antenatal visit.
“I found out I was HIV-positive during my fourth pregnancy,” she told ASHENEWS. “It was overwhelming, but I’ve learned to live with it over the past 14 years.”
Saudatu contracted the virus from her second husband, who passed away in 2003. Since then, she has managed her condition with medication and regular medical care, yet the fear of transmitting HIV to her newborn never fully faded.
Saudatu’s story is not uncommon. According to a 2023 study by the National Institute of Health (NIH), 7 out of every 100 pregnant women in Nigeria are likely to be HIV-positive. Globally, the World Health Organization (WHO) estimates that 1.3 million women and girls living with HIV become pregnant each year, many of them facing the same difficult decisions that Saudatu had to confront.
Without intervention, the risk of HIV transmission from mother to child during pregnancy, labour, delivery, or breastfeeding ranges from 15 per cent to 45 per cent, according to WHO.
However, advances in medical research have brought new hope to mothers like Saudatu. Antiretroviral therapy (ART), a treatment designed to suppress HIV, has proven highly effective in reducing the risk of mother-to-child transmission. Dr. Jamilu Haruna, a Specialist interviewed by ASHENEWS, emphasized the importance of adherence to ART.
“With proper medication and breastfeeding practices, the risk of transmission can be significantly reduced,” Haruna explained. “It is critical to extend testing and ART to all pregnant and lactating women, and ensure they receive continuous support and monitoring throughout the breastfeeding period”.
The balance between tradition and health
For many mothers, breastfeeding is more than just a means of feeding their children—it is a deeply rooted cultural practice. Research consistently highlights the benefits of breast milk, which provides essential nutrients, antibodies, and protection against various infections. Breastfeeding not only satisfies a baby’s nutritional needs but also provides essential protection against various infections and diseases.
This well-documented advantage underscores why many health experts recommend breast milk as the optimal choice for infant nutrition. In addition to these scientific considerations, emotional and cultural factors play a significant role in a mother’s decision to breastfeed, even in areas where a baby’s feeding formula is readily available.
In communities across Nigeria, breastfeeding is viewed not just as a choice but as a societal expectation, making it difficult for HIV-positive mothers to opt for alternatives like baby formula openly.
This cultural expectation adds another layer of complexity for women like Saudatu. In many cases, using formula could raise suspicion about a mother’s health, inadvertently revealing her HIV status and exposing her to social stigma.
Family pressure also plays a significant role. Mothers are often expected to follow traditional practices, and any deviation from the norm can be met with criticism or ostracism from their community.
Amina Ali (not her real name) faced a difficult choice: She had to choose between her baby’s health and the high cost of infant formula. Amina, also living with HIV, struggled with the high cost of baby formula. “It is one of my most challenging moments. I didn’t want to breastfeed because of the risks,” she told ASHENEWS. “But I couldn’t afford the formula, so I was confused.”
It took the intervention of a nurse to have relief. She advised Amina not to skip her antiretroviral therapy (ART) and that by doing such, she could breastfeed her baby with a limited risk of transmission. This advice provided Amina with a practical solution that addressed both her health concerns and financial constraints.
The financial burden of feeding choices
The financial realities of raising a child further complicate the decision-making process for HIV-positive mothers. Infant formula is expensive, and for many families living below the poverty line, it is simply not a viable option. A report from Nigeria’s Bureau of Statistics shows that nearly 40 per cent of Nigerians live in poverty, making access to baby formula out of reach for millions of families.
This forces many HIV-positive mothers to rely on breastfeeding despite the risks involved, especially if they do not have access to adequate medical guidance or ART. This situation underscores the delicate balance HIV-positive mothers must navigate between their health needs and the social implications of their feeding choices.
Amina’s experience is a stark reminder of the importance of accessible healthcare and the need for programs that support low-income families. Her story underscores the broader challenges of HIV-positive mothers who are caught between their financial limitations and their desire to protect their children’s health.
Hope through medical support
For both Saudatu and Amina, proper medical intervention played a crucial role in reducing the risks associated with breastfeeding. Both mothers successfully breastfed their children without transmitting the virus, a testament to the effectiveness of ART and the power of informed medical care.
Their stories serve as a beacon of hope for HIV-positive mothers around the world, demonstrating that with the right support, it is possible to navigate the complex challenges of motherhood while living with HIV.
The WHO has reinforced the need for healthcare systems to prioritize the provision of ART to pregnant and breastfeeding women living with HIV. Dr. Haruna’s insistence on continuous support highlights a gap in the healthcare system that, if addressed, could reduce the rates of mother-to-child transmission significantly.
While progress has been made in reducing the risks of mother-to-child transmission, challenges remain—particularly for women in low-income settings. Addressing these challenges will require a multifaceted approach, including improving access to ART, educating mothers about safe breastfeeding practices, and creating social support systems to reduce the stigma associated with HIV.
The data reflects a broader reality: HIV is not just a medical issue but a social one, deeply intertwined with cultural expectations, economic realities, and the fight for better healthcare access.
As Nigeria continues its battle against the HIV epidemic, the stories of women like Saudatu and Amina are a clear indication that with proper medical guidance and support, it is possible to protect both the mother’s and baby’s health while successfully navigating the challenges of breastfeeding in the context of HIV.
