In Canada, parents living with HIV face complex decisions around infant feeding shaped by medical evidence and social scrutiny, highlighting the need for supportive, non-judgemental approaches to build trust and autonomy amid systemic challenges.
For parents living with HIV, feeding a new baby can be a medical decision and a social one. In Canada, that choice can also be shaped by the fear of family surveillance, a system that can pull families into monitoring and scrutiny under the banner of child welfare. CATIE says parents living with HIV, especially Black, Indigenous and other marginalised families, are more likely to encounter that pressure, which can affect trust, confidence and willingness to seek help.
That concern sits against a changed clinical picture. According to a 2025 commentary in the Canadian Medical Association Journal, breast or chest feeding can be a safe, supported option for people living with HIV who are taking antiretroviral therapy, have a sustained undetectable viral load and remain in care. In those circumstances, the risk of HIV transmission through feeding is very low. The commentary says parents should be supported to choose what works best for them and their infants.
Even so, the legacy of earlier advice still shapes experiences on the ground. CATIE notes that many families continue to face judgement from relatives, service providers and community workers when they discuss formula feeding or breast or chest feeding. That can deepen mistrust, particularly when stigma, racism, poverty, low income, substance use or other barriers are already present. The blog also cites a 2023 Ontario report showing Black children were 7% of the province’s child population in 2016 but 13.9% of those involved in family surveillance investigations. CATIE says nearly 30% of families living with HIV had contact with family surveillance systems, and within that group 32% were Black and 14% Indigenous.
The practical response, the blog argues, is to centre the parent’s autonomy. Community and health workers are urged to provide clear, non-judgemental information on both formula feeding and breast or chest feeding, connect families with informed clinicians, and help them build a wider network of support. CATIE also recommends planning ahead for stress, identifying warning signs, mapping available help and documenting the plan so families have a record of the supports in place if they are ever referred to child protection services. The Teresa Group and Women and HIV/AIDS Initiative are among the organisations highlighted as sources of support.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
