Infant feeding and HIV
Excerpts from the WHO Guidelines on HIV and Infant Feeding 2010:
Balancing HIV prevention with protection from other causes of child mortality
Infant feeding practices recommended to mothers known to be HIV-infected should support the greatest likelihood of HIV-free survival of their children and not harm the health of mothers. To achieve this, prioritization of prevention of HIV transmission needs to be balanced with meeting the nutritional requirements and protection of infants against non-HIV morbidity and mortality.
Integrating HIV interventions into maternal and child health services
National authorities should aim to integrate HIV testing, care and treatment interventions for all women into maternal and child health services. Such interventions should include access to CD4 count testing and appropriate antiretroviral therapy or prophylaxis for the woman’s health and to prevent mother-to-child transmission of HIV.
Setting national or sub-national recommendations for infant feeding in the context of HIV
National or sub-national health authorities should decide whether health services will principally counsel and support mothers known to be HIV-infected to either:
- breastfeed and receive ARV interventions,
- avoid all breastfeeding, as the strategy that will most likely give infants the greatest chance of HIV-free survival.
This decision should be based on international recommendations and consideration of the:
- socio-economic and cultural contexts of the populations served by maternal and child health services;
- availability and quality of health services;
- local epidemiology including HIV prevalence among pregnant women; and,
- main causes of maternal and child under- nutrition and infant and child mortality.
When antiretroviral drugs are not (immediately) available, breastfeeding may still provide infants born to HIV-infected mothers with a greater chance of HIV-free survival
Every effort should be made to accelerate access to ARVs for both maternal health and also prevention of HIV transmission to infants.
While ARV interventions are being scaled up, national authorities should not be deterred from recommending that HIV-infected mothers breastfeed as the most appropriate infant feeding practice in their setting.
Even when ARVs are not available, mothers should be counselled to exclusively breastfeed in the first six months of life and continue breastfeeding thereafter unless environmental and social circumstances are safe for, and supportive of, replacement feeding. In circumstances where ARVs are unlikely to be available, such as acute emergencies, breastfeeding of HIV-exposed infants is also recommended to increase survival.
Informing mothers known to be HIV-infected about infant feeding alternatives
Pregnant women and mothers known to be HIV-infected should be informed of the infant feeding practice recommended by the national or sub-national authority to improve HIV-free survival of HIV-exposed infants and the health of HIV-infected mothers, and informed that there are alternatives that mothers might wish to adopt.
To learn more about the guidelines, please click here.