HIV-1 infection may be transmitted by breast-feeding. The risk of vert
ical transmission varies with the stage of maternal infection, but is
29 per cent if a mother acquires infection during lactation. The risk
of infant death by not breast-feeding in a poor and contaminated envir
onment is greater than the risk of HIV-infection when an HIV-positive
mother breast-feeds. Vertical transmission can be reduced if women avo
id high risk activities during pregnancy and especially lactation.