Health
US pediatricians group reverses decades-old policy, allowing breastfeeding for those with HIV
- People with HIV can breastfeed if they take medications suppressing the AIDS virus, per the American Academy of Pediatrics.
- This marks a significant shift from recommendations since the 1980s.
- Antiretroviral drugs can reduce HIV transmission risk via breast milk to less than 1%.
People with HIV can breastfeed their babies, as long as they are taking medications that effectively suppress the virus that causes AIDS, a top U.S. pediatricians’ group said Monday in a sharp policy change.
The new report from the American Academy of Pediatrics reverses recommendations it had in place since the start of the HIV epidemic in the 1980s.
It recognizes that routinely prescribed drugs can reduce the risk of transmitting HIV via breast milk to less than 1%, said Dr. Lisa Abuogi, a pediatric HIV expert at the University of Colorado and lead author of the report.
BENEFITS OF BREASTFEEDING FOR BOTH MOM AND BABY
“The medications are so good now and the benefits for mom and baby are so important that we are at a point where it is important to engage in shared decision-making,” Abuogi said.
Processed breast milk awaiting distribution is seen at the Breastfeeding Center for Greater Washington on May 19, 2022, in Washington, D.C. People with HIV can breastfeed their babies, as long as they are taking medications that effectively suppress the virus that causes AIDS, a top U.S. pediatricians’ group said on Monday in a sharp policy change. (BRENDAN SMIALOWSKI/AFP via Getty Images)
The drugs, known as antiretroviral therapy, don’t eliminate all risk of transmitting HIV through breast milk. Avoiding breastfeeding is the only certain way to prevent spreading the virus, Abuogi said.
In addition, parents must breastfeed exclusively for the babies’ first six months because research shows that switching between breast milk and formula can disrupt an infant’s gut in ways that increase the risk of HIV infection.
About 5,000 people who have HIV give birth in the U.S. each year. Nearly all take drugs to suppress the virus to very low levels, Abuogi said, though viral levels can rebound if they don’t stay on them.
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Before the medications became widely available starting a decade ago, about 30% of HIV infections transmitted from moms to babies occurred during breastfeeding, said Dr. Lynne Mofenson, an adviser to the Elizabeth Glaser Pediatric AIDS Foundation. In the early 1990s, about 2,000 infections occurred in U.S. infants each year. Today, it’s fewer than 30.
The AAP policy comes more than a year after the National Institutes of Health and the Centers for Disease Control and Prevention reversed longstanding recommendations against breastfeeding by people with HIV. That guidance said people who have consistent viral suppression should be counseled on their options. It also emphasizes that health care providers shouldn’t alert child protective services agencies if a parent with HIV seeks to breastfeed.
The goal is listening to patients “and not blaming or shaming them,” said Dr. Lynn Yee, a Northwestern University professor of obstetrics and gynecology who helped draft the NIH guidance.
Breastfeeding provides ideal nutrition for babies and protects them against illnesses and conditions such as obesity and Type 2 diabetes, research shows. Nursing also reduces the mother’s risk of breast and ovarian cancer, diabetes and high blood pressure.
The World Health Organization has recommended since 2010 that women with HIV in developing countries breastfeed their infants and have access to antiretroviral therapy. The guidance weighed the risk of infants acquiring HIV through breastfeeding and the risk of babies dying from malnutrition, diarrhea and pneumonia in places where safe replacements for breast milk aren’t available.
In developed nations, however, experts had recommended against breastfeeding because the wide availability of safe water, formula and human donor milk could eliminate the risk of HIV transmission, Yee said.
That frustrated people with HIV who were flatly refused the option of nursing.
Ci Ci Covin, 36, of Philadelphia, said she was diagnosed with HIV at age 20 and not permitted to breastfeed her first child, Zion, now 13.
“I couldn’t understand how come my sister that lives in a place like Kenya, who looks just like me with the same color brown skin, was given the option to breastfeed and how my option was starkly no,” she said.
Not being able to nurse her son sent Covin into a spiral of postpartum depression, she said. When she became pregnant with her now 2-year-old daughter, Zuri, her health care team helped her successfully breastfeed for seven months. Covin took her prescriptions as directed and also gave the baby drugs to prevent infection.
“Breast milk has everything in it that my baby would need,” Covin said. “That’s a beautiful thing.”
Abuogi said the AAP report provides crucial guidance for pediatricians, nurses and lactation specialists who work directly with children and families.
Some providers were already helping people treated for HIV to nurse their babies, despite the earlier recommendations. The new guidance should expand the practice, hopefully quickly, Abuogi said.
“This is a unique situation because it’s not just doctors and providers who are changing,” Abuogi said. “Our patients are pushing this as well.”
Health
Scientists pinpoint why COVID vaccine may trigger heart inflammation in certain people
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POST-DOSE PATTERN — New research reveals why the COVID vaccine can trigger heart issues, especially in one group
PREVENTION PAYOFF — Simple lifestyle changes could slash heart attack risk for millions
A new study has identified why mRNA COVID-19 vaccines could trigger heart issues, especially in one demographic. (iStock)
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HIDDEN LINK — A common dental health issue may hint at a dangerous cardiovascular condition
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SCREENING DEBATE — A new study questions whether annual mammograms are necessary for most women
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The flu season has intensified as the new H3N2 variant causes severe illness worldwide. (iStock)
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Health
Aging-related joint disorder increasingly affects people under 40, study finds
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Cases of gout are rising in younger individuals, according to a global study.
The condition, which is a type of inflammatory arthritis, steadily increased in people aged 15 to 39 between 1990 and 2021, researchers in China announced.
Although rates vary widely between countries, the total number of young people with the condition is expected to continue rising through 2035.
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The study, published in the journal Joint Bone Spine, investigated 2021 data from the Global Burden of Disease (GBD), spanning 204 countries within the 30-year timeframe.
The data measured gout prevalence, incidence and years lived with disability, tracking global trends over time. The results showed a global increase across all three outcomes.
Gout is expected to continue rising in young people through 2035. (iStock)
Prevalence and disability years increased by 66%, and incidence rose by 62%. In 2021, 15- to 39-year-olds accounted for nearly 14% of new gout cases globally, the study found.
Men from 35 to 39 years old and people in high-income regions had the highest burden, but high-income North America topped the list for highest rates.
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Men were also found to have lived more years with gout due to high BMI, while women tended to have the condition as a link to kidney dysfunction, the study noted.
The total number of cases is expected to increase globally due to population growth, but the study projected that rates per population would decrease.
The researchers noted that data quality, especially in low-income settings, could have posed a limitation to the broad GBD data.
What is gout?
Gout is a common form of arthritis involving sudden and severe attacks of pain, swelling, redness and tenderness in the joints, according to Mayo Clinic. It most often occurs in the big toe.
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The condition occurs when urate crystals accumulate in the joint. These form when there are high levels of uric acid in the blood, which the body produces when it breaks down a natural substance called purines.
A gout flare-up can happen at any time, often at night, causing the affected joint to feel hot, swollen, tender and sensitive to the touch.
Urate crystals, described as sharp and needle-like, build up in the joint, causing intense pain and swelling. (iStock)
Purines can also be found in certain foods, like red meat or organ meats like liver and some seafood, including anchovies, sardines, mussels, scallops, trout and tuna, according to the Mayo Clinic. Alcoholic drinks, especially beer, and drinks sweetened with fruit sugar can also lead to higher uric acid levels.
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Uric acid will typically dissolve in the blood and pass through the kidneys into urine, but when the body produces too much or too little uric acid, it can cause a build-up of urate crystals. These are described by the Mayo Clinic as sharp and needle-like, causing pain, inflammation and swelling in the joint or surrounding tissue.
Risk factors for gout include a diet rich in high-purine foods and being overweight, which causes the body to produce more uric acid and the kidneys to have trouble eliminating it.
Experts urge patients to seek medical attention for gout flare-ups. (iStock)
Certain conditions like untreated high blood pressure, diabetes, obesity, metabolic syndrome and heart and kidney diseases can increase the risk of gout, as well as certain medications.
A family history of gout can also increase risk. Men are more likely to develop the condition, as women tend to have lower uric acid levels, although symptoms generally develop after menopause.
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Untreated gout can cause worsening pain and joint damage, experts caution. It may also lead to more severe conditions, such as recurrent gout, advanced gout and kidney stones.
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The Mayo Clinic advises patients to seek immediate medical care if a fever occurs or if a joint becomes hot and inflamed, which is a sign of infection. Certain anti-inflammatory medications can help treat gout flares and complications.
Fox News Digital reached out to the researchers for comment.
Health
New study questions whether annual mammograms are necessary for most women
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A new study suggests that annual mammograms may not be the only effective approach for preventing breast cancer.
The research, published in the Journal of the American Medical Association (JAMA), tested a risk-based breast cancer screening approach against standard annual mammography.
The WISDOM randomized clinical trial, led by study authors from universities and healthcare systems across the U.S., considered more than 28,000 women aged 40 to 74 years old, splitting them into a risk-based screening group and an annual mammography group.
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Researchers calculated each woman’s individual risk based on genetics (sequencing of nine breast cancer genes) and other health factors.
A new study suggests that annual mammograms may not be the only effective approach for preventing breast cancer. (iStock)
Those who were at the highest risk were advised to alternate between a mammogram and an MRI scan every six months. Patients with elevated risk were told to get an annual mammography and counseling.
Average-risk women were guided to get mammograms every two years, while low-risk individuals were advised to have no screening until they became higher risk or reached age 50.
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The researchers found that risk-based screening did not lead to more advanced cancer diagnoses (stage 2B or higher) compared with annual screening, indicating that it is just as safe as traditional methods. The risk-based approach, however, did not reduce the number of biopsies overall, as researchers had hoped.
Among the risk-based group of women, those with higher risk had more screening, biopsies and detected cancers. Women at lower risk had fewer procedures.
The research, published in the Journal of the American Medical Association (JAMA), tested a risk-based breast cancer screening approach against standard annual mammography. (iStock)
“[The] findings suggest that risk-based breast cancer screening is a safe alternative to annual screening for women aged 40 to 74 years,” the researchers noted in the research summary. “Screening intensity matched individual risk, potentially reducing unnecessary imaging.”
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Fox News medical contributor Dr. Nicole Saphier, associate professor of radiology at Memorial Sloan Kettering Cancer Center in New Jersey, commented that while these findings are important, the study “completely sidelines” what screenings are designed to do — detect cancer early.
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“If you don’t measure stage 0, stage 1 or stage 2A cancers, you can’t tell whether personalized screening delays diagnosis in a way that matters for survival and treatment intensity,” Saphier, who was not involved in the study, told Fox News Digital in an interview.
Those who were at the highest risk were advised to alternate between a mammogram and an MRI scan every six months. (iStock)
More than 60% of breast cancers in the U.S. are diagnosed at stage 1 or 2A, where cure rates exceed 90%, the doctor noted.
The trial doesn’t “fully evaluate” whether risk-based screening changes detection at the earliest and most treatable stages, where screening “delivers its greatest benefit,” according to Saphier.
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“Mammography is not without risk — radiation exposure, false positives, anxiety and potential over-diagnosis are real and should be acknowledged,” she said. “But it remains the most effective, evidence-based tool for detecting breast cancer early, when treatment is most successful.”
The expert added that labeling women under 50 as “low risk” is “outdated,” as breast cancer diagnoses are on the rise in younger females.
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“Until long-term mortality data support alternative approaches, annual screening beginning at 40 for average risk women should continue,” Saphier added. “Women should be assessed for breast cancer risk by 25 years old to determine if screening should begin earlier.”
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