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DATA BRIEFS:  (Continued)

HIV and infant feeding

A child whose mother is HIV positive runs a risk, presently estimated to be at least 1 in 7, of acquiring the virus through breastfeeding. About 500 to 700 infants are infected this way every day, but the exact mechanism of transmission is still not fully understood.

Before the terrible spectre of HIV/AIDS emerged, breastfeeding was recognized as the best way to feed infants in virtually all circumstances. Now, given the possibility of transmitting HIV through breastfeeding, joint WHO/UNICEF/UNAIDS guidelines on infant feeding have been issued to assist policy makers and health workers in addressing that risk and helping to safeguard the rights of mothers and their children. Central to these guidelines is the right of mothers to make decisions, on the basis of full and clear information, on what is best for them and their infants and to be supported in carrying out those decisions.

The guidelines warn of the potential harm in mixing breastfeeding and artificial feeding. Indeed, recent findings suggest that this combination may be particularly dangerous to infants. A new study of babies up to three months of age born to infected mothers suggests that those who are exclusively breastfed may face a significantly lower risk than was previously thought.

The study posits that feeding other solids or fluids in addition to mother's milk in the first months of life may be what injures the baby's gut and allows the deadly HIV virus to enter body tissues. Additional research is urgently needed to further pursue these important early findings.

In the meantime, it remains critical to prevent 'spillover' of artificial feeding to women who can safely breastfeed. This is best done through continued efforts by governments to implement the International Code of Marketing of Breastmilk Substitutes.

The guidelines also call for access to voluntary and confidential HIV counselling and testing for women and men. Women who are aware of their HIV status should be counselled on the risk of HIV transmission to their babies, and on the benefits and risks of all the various infant feeding options.

Women who are HIV negative, or who do not know their status, should be informed of the benefits of breastfeeding and of the particular importance of avoiding infection in the future.