With the growing concern about childhood HIV infection, a clear understanding of how children are infected is becoming more important. Obviously, with infection rates so high in the adult population, more children are being born infected. But for those that aren’t infected at birth, there is another danger according to a South African study: shared breastfeeding.

Dr Olive Shisana, executive director of Social Aspects of HIV/AIDS and Health at the HSRC, told IRIN that although there was no doubt of the capabilities of public healthcare staff at the hospitals where the study was conducted, gaps still remained.

“A major problem was that bottles were labelled by cot numbers - rather than by the name of the baby - and rarely checked, allowing milk to be fed to the wrong baby if the cot was moved. This suggests that even if children are born free of HIV, they are likely to contract the virus through breastfeeding,” Shisana explained.

Of the 4,000 mother-and-child pairs studied at 25 hospitals, close to 30 percent of mothers were HIV positive, while children in the two to nine age group had an HIV prevalence of 14.9 percent.

Only 13 of the 25 sites had dedicated milk-preparation areas; at the remaining sites milk was prepared in maternity wards with few infection prevention methods.

That the problem is this pronounced in one of the most stable and advanced countries in sub-Saharan Africa would seem to indicate that it would be even worse in less developed nations. HIV/AIDS prevention programs in Africa tend to focus on sexual transmission, but the best plans need to be more far ranging. Things like sterilization of medical instruments and proper preparation of breast milk are as important in helping to contain the virus (as well as being more hygienic and safer in a general sense).

As with most problems throughout Africa, solutions are neither simple nor cheap. Any one silver bullet doesn’t solve economic development, self-sufficient farming, political stability, education, and crumbling infrastructures. Combating the spread of HIV will, similarly, require multiple tools and tactics; and, like those other problems, the solution both impacts and is impacted by the other issues. Understanding how the problem grows is vital; this study is a great step in gaining that understanding.

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