Celebrate Solutions: Simple Technologies Prevent Transmission of HIV During Breastfeeding

By: Madeline Taskier, Partnership Coordinator at Women Deliver

In honor of World Breastfeeding Week, I’d like to highlight a new innovation that has the potential to save the lives of babies born to HIV-positive mothers. With support from the Bill and Melinda Gates Foundation, researchers from Family Health International, University of Cambridge, Drexel College of Medicine, and PATH have developed a low-cost nipple shield which will deliver HIV preventative compounds to a newborn during breastfeeding.

Over 200,000 babies are infected with HIV every year through breastfeeding, making up nearly 40% of the total number of HIV infections acquired by newborns through all forms of mother-to-child transmission.  HIV-positive mothers often have little or no access to safe or sustainable sources of infant formula and are advised to exclusively breastfeed their babies for the first 6 months as it is the most nutritious option for the newborn. When mothers exclusively breastfeed they are two to three times less likely to transmit the infection than when a mother mixes breastfeeding and other foods.  

In low-resource settings, the use of the infant formula has been connected to increased infant malnutrition, diarrhea, and death. Recognizing the need for HIV-positive mothers to protect babies from HIV in breast milk and to allow normal, practical breastfeeding, JustMilk has created a technology to accomplish this.    

The JustMilk Nipple Shield is a breast milk filter with a microbicide filter attachment that easily inserts into the tip of the shield. The shield is nipple-shaped, typically made of silicone with holes allowing for breast milk to pass through. The filter attachment could be modified to deliver not only a microbicide preventing transmission, but also ARVs such as prophylaxis, nutritional supplements, or pediatric antibiotics.  

The team at JustMilk uses six main criteria to measure success of the technology: low cost; acceptability by the mother and the baby; easy to clean and maintain; fast use; and no nutritional side effects. Initial studies and anecdotal evidence are being collected in Tanzania, Malawi, and Zimbabwe.

A key piece of evidence has shown that mothers not visibly breastfeeding their newborns draw unwanted attention to themselves as it raises speculation about their HIV status. Fortunately, the nipple shield is private, and also easy to use on a daily basis. While still in the beginning research phases, JustMilk holds great promise for mothers looking to breastfeed their babies, prevent HIV transmission, and maintain their privacy.