Durban academic at forefront of fight against HIV

PASSION, empathy and extensive research have put a Durban academic at the forefront of the fight against the HIV/Aids infection among young children in South Africa. Prof Anna Coutsoudis, a leading expert in mother-to-child transmission of the HI virus, has proved together with her colleagues that breastfeeding for the first six months of a baby’s life has resulted in a twofold reduction in the risk of transfer of the virus. While a raft of academic accolades and achievements arouse interest, it is rather Coutsoudis’s intense passion and humanity that draws attention: demanding questions on how something so simple, so natural, so ridiculously reasonable and cost-free has been dismissed, and in fact advised against, by medical practitioners since the emergence of the disease. A professor in the department of paediatrics and child health at the University of KwaZulu-Natal’s Nelson R Mandela School of Medicine, Coutsoudis says when it was proved that the virus could be transmitted through breast milk, the immediate reaction by medical authorities was to put a stop to breastfeeding. “My research started with showing the risk factors if children were not fed breast milk only by their mothers,” said Coutsoudis. “Many newborns in poverty-stricken areas – where the cost of milk formula is prohibitive – are fed herbal teas and cereals, often when they are less than two months old. “This results in damage to the gut. As soon as you get breaks in the gut wall, the virus then has a way to get into the system. While the first findings weren’t enough to get the World Health Organisation (WHO) to change its policies, four subsequent independent studies have proved my theory. It is now recommended by the WHO that exclusive breastfeeding is recommended for babies for the first six months – even where the mothers are HIV-positive.” Coutsoudis says the local Department of Health is beginning to embrace the guidelines developed by the WHO. “They are quite excited about the flash-heating method which we also developed. This is a simple process of heating up expressed breast milk to kill any viruses that may be present. Once cooled, the milk can then be safely fed to the infant, providing the essential nutrition newborn and growing babies need with safety. “There is nothing better for babies than breast milk. Yet, somehow people have been blinded into believing that replacement formulas are better. Nothing can be further from the truth.” In 2001, Coutsoudis founded the iThemba Lethu transition home for babies abandoned or orphaned as a result of HIV/Aids. “Since 2001, we’ve had 49 babies – a few have been HIV-positive – through the home who have all been adopted or have been reunited with their extended families. They come to the home very sick, often traumatised and most suffering from severe malnutrition. By feeding them only breast milk, their recovery is not only remarkable but dramatic,” she said. When The Mercury visited the beautifully appointed Cato Manor home last week, which is designed to accommodate 12 babies, six were under the care of social workers and local and international volunteers. A garage attached to one of the homes is now a sophisticated, sterile and hi-tech storage for donated breast milk. Coutsoudis said it had been her vision since its inception that the home would be an example of best practice in the care of abandoned babies. “We are really excited about the community breast milk bank. A company that makes pasteurising machines for the dairy industry made a special prototype for us and we are awaiting a breast milk homogeniser and analyser we have sourced from Sweden. Penny Reimer heads it up and about 32 HIV-free mothers of newborn babies are donating milk. Penny’s job is to go around collecting it all, pasteurising and freezing it for later use. Up until now, we have used the milk only for the orphans at the home, but hospitals are now calling on us to assist them, particularly when they have very sick babies who cannot keep any food down.” Coutsoudis, who has also facilitated the founding of community breast milk banks in Johannesburg and Cape Town, says in the United States the milk has become a highly sought-after and costly commodity. “We have formed a regulatory body, the Human Milk Banking Association of South Africa, not only to promote the concept but to make sure someone doesn’t see an opportunity to make a quick buck. I would be very said if that ever happened.”