JustMilk, the nipple shield for preventing mother to child transmission of HIV

(adapted from  article in the Weekend Nation, Malawi – Lifting the Lid on HIV and AIDS 2nd April 2011)

Modifying technology might be the solution to curbing the spread of HIV and AIDS.  JustMilk nipple shield is a low cost, modified nipple shield that releases antiviral compounds to reduce HIV transmission from mother to baby during breastfeeding.

The JustMilk nipple shield is the work of scientists at the University of Cambridge with collaborators from the United States. A nipple shield is a nipple shaped flexible plastic covering worn over the nipple during breastfeeding. Nipple shields are used in various situations: to help young babies who have problems latching onto the breast, for women with irregular nipples that point inside the breast, for mothers with cracked nipples or for babies who are used to the plastic bottle teat.

Research shows that approximately 200,0000 babies contract HIV from breastfeeding each year in sub-Saharan Africa. HIV positive mothers often have no alternative than to breast feed as formula feeding can be very risky. Formula feeding in low resource settings is either not provided adequately or regularly resulting in malnutrition in the baby and is often made with unsafe drinking water which causes diarrhoea.

Image courtesy of JustMilk (http://justmilk.org/)

The nipple shield is meant to be a low cost option for HIV-positive mothers. Think of the nipple shield as a breast milk filter. Inside the filter are antiviral agents that reduce the likelihood of HIV transmission by either reducing the amount of virus in the milk or providing partial protection within the infant against infection. The study is also investigating the delivery of medications and nutritional supplements through the modified nipple shield.

Their approach involves modifying an existing commercial nipple shield by adding replaceable inserts (e.g. cotton-wool) that contain antiviral agents that inactivate the HIV without harming the baby. This allows the mother to directly feed the baby rather than having to collect and heat the milk (currently the only established method of treating HIV infected breast milk), which can result in social stigma. Anti-HIV agents have been identified that do not have a detrimental impact on the nutritional content of milk, and initial research and laboratory tests performed by the team indicate this idea may be feasible.