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WHO/UNAIDS/UNICEF infant feeding guidelines

UNICEF/HQ92-0259/ LAUREN GOODSMITH

A Moor woman breastfeeds her baby outside her home in the village of Teyarett in the Adrar region. More than 50% of the population, Mauritanian women bear heavy workloads, suffer from anaemia and vitamin A deficiencies and a high maternal mortality rate of 700/100,000 live births as well as low literacy rates.

Current WHO/UNAIDS/UNICEF infant feeding guidelines can be summarised as follows:

1. For women who are known not to be infected with HIV, and for women whose infection status is unknown, protect, promote and support exclusive breastfeeding for 6 months, followed by continued breastfeeding, together with appropriate complementary feeding, for up to two years of age or beyond.

2. All HIV-infected mothers should receive counselling, which includes provision of general information about the risks and benefits of various infant feeding options, and specific guidance in selecting the option most likely to be suitable for their situation. Whatever a mother decides, she should be supported in her choice.

3. When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-positive mothers is recommended; otherwise, exclusive breastfeeding is recommended during the first months of life.

4. HIV-infected mothers who breastfeed should be assisted to ensure that they use a good breastfeeding technique to prevent breast conditions like mastitis, breast abscesses and nipple fissures, which should be promptly treated if they occur.

5. To minimise HIV transmission risk, breastfeeding should be discontinued as soon as feasible, taking into account local circumstances, the individual woman's situation and the risks associated with replacement feeding (including infections other than HIV and malnutrition).

6. HIV-infected mothers who breastfeed should be provided with specific guidance and support when ceasing breastfeeding to avoid harmful nutritional and psychological consequences and to maintain breast health.

7. When HIV-infected mothers choose not to breastfeed from birth or stop breastfeeding later, they should be provided with specific guidance and support for at least the first 2 years of the child's life to ensure adequate replacement feeding. Programmes should strive to improve conditions that will make replacement feeding safer for HIV-infected mothers and families.

8. HIV-infected women should have access to information, follow-up clinical care, and support, including family planning services and nutritional support.

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