In the news ... 2008

Inventive nipple shield may prevent HIV transmission

by Alan McCord, September 30, 2008

Efforts to reduce HIV transmission from breastfeeding got a boost this month from an engineer who created a device called an HIV nipple shield. The device, presented at the International Development Design Summit in Cambridge, MA, was fashioned by a team of university students headed by British chemical engineer, Stephen Gerrard. This development was first reported by BBC News.

The innovative device adapted an existing nipple shield to cover a woman’s breast during breastfeeding. The device is made of a thin layer of silicone with a very thin cotton pad that would cover a woman’s nipple. The cotton pad contains sodium dodecyl sulphate (SDS), which is a detergent that scientists use to break down proteins in lab study. As breast milk passes through the cotton pad, HIV is then allegedly deactivated before reaching the newborn. SDS is being used by a research group at Drexel University to kill HIV in fairly non-toxic amounts.

Women living with HIV can pass the virus onto their newborns through breastfeeding. Several methods to rid breast milk of HIV are already being studied. One is heating breast milk to rid it of HIV, which may be impractical. A second method uses copper and copper compounds to filter HIV. Another method, replacing breast milk with formula, is already used in some areas of the world, though it’s often complicated by stigma and lack of clean drinking water.

Several concerns remain about the device. One is that the shield could easily identify a woman as living with HIV. How that would be handled is unclear at this point, though Gerrard believes it could be marketed as a way to deliver medicines or nutritional supplements. Another concern is how well newborns are able to nurse through the shield, as well as what possible harm could come from ingesting any SDS residue in the breast milk. Most importantly, the device’s efficacy has not been confirmed by rigorous independent study.

Though Gerrard states that the nipple shield “filters” the HIV from breast milk, the device is far from actually being used for HIV prevention. The shield will likely have to go through two or more years of clinical study to assess its effectiveness. Even so, the shield offers a much simpler “fix” to preventing HIV transmission through breastfeeding over the other methods currently being studied.

This development presents great hope to women in resource-poor areas of the world where other prevention methods are difficult if not impossible to engage. It is innovation such as this that could collectively result in the eventual cure for HIV.