Gracelove

Gracelove chose to breastfeed her new baby for its nutritional and bonding benefits. She was comfortable breastfeeding as she had breastfed her older child (born before her HIV diagnosis).

Gracelove was diagnosed with HIV in 2017. She migrated to the UK from Western Africa 20 years ago. Initially, Gracelove had believed her HIV symptoms were a sign of pregnancy, so when she received her diagnosis she was in denial. Moreover, her husband had told her that it could not be true, as he had been tested and was HIV negative. Her church leader also denied her HIV diagnosis and suggested that she must be pregnant. Although Gracelove did not believe the diagnosis, she kept attending the HIV clinic and the medical staff continued to test her and give her a positive diagnosis. In 2019, Gracelove began HIV treatment and within a week she was undetectable.

Gracelove and her husband had been living separately from each other; he in Western Africa and her in the UK. When he moved to the UK, Gracelove registered him at the GP and took him for a sexual health screening. When his HIV test came back positive, Gracelove felt betrayed. Around the same time, she was pregnant with her youngest child.

Gracelove chose to breastfeed her baby because she believes that breastfeeding provides more opportunity for bonding, boosting the baby’s immunity to childhood infections and providing additional nutrients, compared to formula. Gracelove’s HIV clinic were supportive of her decision and gave her advice about how to breastfeed safely. They also advised her to express colostrum ahead of birth and freeze breastmilk to store in case she was ill at any time and could not breastfeed from the nipple. Gracelove breastfed for 4 and a half months and found it easy to do. She decided to stop breastfeeding so that she could introduce her baby to solid food, and also because she wanted to take the Covid-19 vaccine and wished to stop breastfeeding beforehand.

To transition her baby from breastfeeding to formula, she began to give her baby breastmilk in a bottle, so that her baby would get used to the sensation. Once her baby was formula feeding, Gracelove also gave her porridge and other soft foods.

Gracelove found the monthly blood tests for her baby comforting, as it reassured her the baby did not have HIV. Before she stopped breastfeeding, her HIV clinic asked her how she felt about starting formula feeding. Gracelove told them she was worried about the cost of formula, as she was currently unemployed and receiving Universal Credit. Her clinic referred her to a charity that would provide her free formula milk up until her baby was 1 year old.

Gracelove has felt isolated since her diagnosis as she has not shared it with anyone for fear of their reaction, although she does attend an HIV charity support group for mothers and babies. She did not discuss her infant feeding decision with her husband, as they had separated before she gave birth.

Gracelove breastfed her baby for four months and then switched to formula, which she found straightforward to do.

Age at interview 38

Age at diagnosis 34

I think for some reason that transition has really sort of worked out. She appears to sort of when I first, when I first introduced her to the bottle, she didn’t want it so that was, I sort of felt, ‘oh if she now refuses the bottle what do I do?’ you know, but then with persistence she started to take the bottle and then when I change the formula as well because she was already on the breastmilk in the bottle, she accepted it straight away. I don’t know if she knew the difference, but she took it and also now that I’ve introduced food, I started with pureed, she seemed to take it okay.

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Gracelove found HIV monitoring reassuring that breastfeeding would be safe.

Age at interview 38

Age at diagnosis 34

Oh baby is fine during the pregnancy we had to undergo I had to take blood tests just to monitor me before birth because I was told at any time that I become detectable, it might affect my choices being able to proceed or not but then throughout I’ve been undetectable until she was born and then after that both of us we’ve been having our blood test done and so I stopped breastfeeding so she’s only got one more blood test to do and then that’ll be it. And so far, all the blood tests have come back negative, okay.

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Gracelove chose to stop breastfeeding after 4.5 months to make feeding more convenient.

Age at interview 38

Age at diagnosis 34

I wanted it to sort of introduce her to food because I felt each, she became fuller then I would have longer nights [laughs] of sleep. Yeah because the nights have been like a bit, a bit of a nightmare having to deal with my eldest and her and it’s just us and the school runs and everything, you know. I feel it’s, it was taking a toll on me as well, so I know it sort of worked out that, but I didn’t want to stop. When it got to the time that I know from the beginning I said to myself I’ll breastfeed until four and then along the line, I sort of felt, ‘oh maybe I could do it for six months,’ you know, but then when I thought about her eating and being full and sleeping well and you know, being able to take care of both of them because as I said her big sister is also one chatty box, full of energy and to be able to cope with the two of them is not easy so yes.

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Gracelove had several conversations with her clinical team during and after her pregnancy.

Age at interview 38

Age at diagnosis 34

When I was pregnant, they said to me that “After I’d given birth would I want to breastfeed or would I stay on formula?” because I was given that choice so I said, “I would like to breastfeed.” So then they now referred me to the, this conversation was initiated by the midwife and then they brought in a paediatrician I think from the clinic who came and spoke to me about the options for breastfeeding more and what the procedure would be after birth that she would have to take some medication and how long she would take the medication for and the blood test that she would have to undergo. Yes so she spoke to me about that and it wasn’t in one session I met up with her three times before I gave birth, to speak about the breastfeeding and what to expect and the time that I needed to sort of express and how long I wanted to breastfeed and the fact that both of us have to be healthy, no diarrhoea, no stomach, you know, doing for both of us in order for the breastfeeding to sort of take place and that at any time I sort of felt unwell or she felt unwell then we might have to stop the breastfeeding and I was also advised, I was also advised to express and then freeze, freeze it just in case I became unwell and I didn’t want to stop then I could use the frozen once I became well enough to be breastfeeding but then during that time I would have to express and pour away if that was the scenario.

Yes so I was advised to express before birth so that she can have that because that will build her immunity that build her immunity because after three days, three days of birth, the colostrum runs out and it becomes breast milk, so yes, I expressed a bit before giving birth.

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Gracelove had to continually educate her health visitors that she couldn’t mix feed her baby.

Age at interview 38

Age at diagnosis 34

She was glad that I was giving her the right information from the consultant, so she said, “Oh she’ll, she’ll take note of that.” But then in no time she went away and then transferred me to another person and that person as well said the same thing, said the same thing that she wasn’t aware that we couldn’t mix feed. So, the message is not really being given to all the health visitors I would say.

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Gracelove was in denial when she first received her diagnosis, as she thought her symptoms were due to being pregnant.

Age at interview 38

Age at diagnosis 34

I did not believe the diagnosis because I didn’t feel I had any symptoms that sort of showed that I wasn’t unwell and the symptoms that I felt that I was pregnant and then when I was diagnosed, I did mention it to my husband then of which he said the diagnosis cannot be possible because he has had similar tests done at his workplace and he is not positive. And I know for sure because it’s me, I know myself, I know after I married with him, I have never been with any other person, and during my first birth it was natural delivery, vaginal delivery.

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