A 31-Year-Old Woman, Gravida 1 Para 0, at 14 Weeks

A 31-year-old woman, gravida 1 para 0, at 14 weeks gestation comes to the office to establish prenatal care.  She has had some nausea but no vomiting, abdominal pain, or vaginal bleeding.  The patient contracted HIV through intravenous heroin use.  She was diagnosed 3 years ago while hospitalized for drug rehabilitation.  The patient is on triple-combination antiretroviral therapy with no significant side effects.  She has no other chronic medical conditions and has had no previous surgeries.  In addition to her HIV medications, the patient takes a daily prenatal vitamin.  She does not use tobacco or alcohol and has not used illicit drugs since rehabilitation.  Temperature is 36.7 C (98.1 F) , blood pressure is 110/60 mm Hg, and pulse is 65/min.  BMI is 24 kg/m².  Pelvic examination reveals a 14-week-sized nontender uterus with no adnexal masses.  Laboratory results are as follows:
Bedside ultrasound reveals a 14-week intrauterine pregnancy with a normal heart rate.
The patient is compliant with highly active antiretroviral therapy (HAART) throughout pregnancy.  She continues to abstain from tobacco, alcohol, and illicit drugs.  The patient has an uncomplicated delivery at 38 weeks gestation and indicates that she would like to breastfeed her child.  Which of the following is the most appropriate recommendation?

A) Breastfeeding is safe if the mother and infant are both on HAART
B) Breastfeeding is safe if the mother and infant take zidovudine
C) Breastfeeding is safe if the mother is on a 3-drug HAART regimen
D) Breastfeeding is safe if the mother takes zidovudine
E) The infant should be formula-fed and not breastfed