Whether in developing or developed countries, the world's more than 2.1 million HIV-positive children are likelier to survive and thrive with good nutritional support. With access to proper food and health care, many can even live into adulthood. If you are the parent or other caregiver of an HIV-positive child, learn all you can about the vital role of nutrition in HIV care. Bring any questions you have to your health worker's attention.
Pregnancy
If you are HIV-positive and pregnant, please ask your health-care professionals about antiretroviral drug regimens and safer birthing options. These can both boost your own health and help prevent transmission of the virus to your baby. HIV-positive mothers are more vulnerable to birthing premature and underweight babies. All pregnant women need to take in more nutrients, including folic acid, calcium and iron, as well as more protein and overall calories. Most need to gain weight and take prenatal vitamins. Yet side effects from antiretrovirals and morning sickness may cause appetite-curbing symptoms like heartburn, constipation, nausea or vomiting. Antiretrovirals can also lead to gestational diabetes. CATIE, the Canadian AIDS Treatment Information Exchange, publishes a nutrition guide with practical strategies for managing these problems.
Breastfeeding
Breastfeeding by HIV positive mothers carries a 16 percent risk of transmitting the virus. In wealthier countries where clean water and commercial infant formula are commonplace, HIV-positive mothers are generally advised not to breastfeed. For poorer countries, the World Health Organization publishes guidelines for decision-making. For some babies in some situations, the risk of death can actually be greater from not breastfeeding than from doing so.
Growth and Weight Concerns
Health professionals need to periodically evaluate the growth, weight and nutritional status of HIV-positive children. They are more vulnerable to lower than normal weights and heights, growth failure and muscle wasting, which are associated with higher mortality. At the same time, because of diarrhea, vomiting and loss of appetite, HIV-positive children may sometimes have trouble eating enough by mouth. Sometimes oral nutritional supplements and tube feedings are beneficial and lifesaving. Antiretoviral drugs reduce these growth and weight problems yet can also have a side effect known as lipodystrophy, especially during puberty. Lipodystrophy distributes body fat abnormally and raises certain blood lipids, or fats.
Planning Ahead
Stocking a healthy pantry, planning meal menus and having regular family meals can help ensure that your child gets enough calories, protein and other necessary nutrients. These can also become ways to engage your child in his own nutritional health, allowing for that responsibility to shift gradually over the years onto his shoulders.
Food and Water Safety
Like all people with weakened immune systems, HIV-positive children have a greater risk of infectious diseases, including those borne by contaminated food or water. Building clean food and water precautions into your family's everyday and travel routines can help safeguard your child. CATIE's nutrition guide lists a number of effective strategies.
References
- "Journal of Parenteral and Enteral Nutrition"; Nutrition Support of Children With Human Immunodeficiency Virus Infection; N. Sabery et al.; Sept. 2010.
- AVERT: WHO HIV & AIDS guidelines for Preventing Mother to Child Transmission, PMTCT, & Breastfeeding
- CATIE, Canadian AIDS Treatment Information Exchange: A Practical Guide to Nutrition for People Living With HIV
- UNAIDS: 2009 AIDS Epidemic Update
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