Methods The records of 119 children, either infected with HIV or born to HIV-infected mothers were reviewed. This group was mainly represented by children whose families came to Belgium from Central Africa. Seven children were infected through blood or blood products transfusion, whereas the remaining 112 were born to infected mothers. Most of the latter were infected through heterosexual contacts. Results The overall rate of perinatal transmission was 44%. The transmission rate observed in our population is higher than in other European studies and closer to African studies. Lymphadenopathy was observed in 86% of infected children versus 16% in noninfected children during the first year of life (p =.0002). Serum IgG level was higher in infected children than in noninfected children. Conclusions HIV transmission is firmly related to breast feeding.