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The Response: Key Principles and Strategies

In 1997 in Nigeria, a woman smiles while breastfeeding her baby girl at Kaduna Hospital in Kaduna, capital of the northern state of the same name.

The risk of HIV-infection has to be compared with the risk of morbidity and mortality due to not breastfeeding. Breastfeeding is protective against death from diarrhoea, respiratory and other infections, particularly in the first months of life. Breastfeeding also provides the necessary nutritional and related ingredients, as well as the stimulation necessary for good psychosocial and neurological development, and contributes to birth spacing.

So, for HIV-infected mothers, especially in developing countries, the decision to breastfeed or to give breastmilk substitutes like infant formula or modified cow's milk provides a dilemma. While breastfeeding increases the risk of HIV-transmission to the child with up to 15%, giving breastmilk substitutes instead of breastmilk increases the risk due to infectious diseases like diarrhoea and respiratory infections about 6 times during the first 2 months. Many mothers in developing countries cannot afford breastmilk substitutes and lack access to clean water, which is essential for their safe preparation and use. Also in many cultures there is a stigma against not breastfeeding. A mother living with HIV/AIDS therefore faces many grave difficulties: worries about her own health and survival, the risk of infecting her baby through breastmilk, and the danger that her baby will develop other health problems if she does not breastfeed.

The United Nations General Assembly Special Session on HIV/AIDS in June 2001 generated an unprecedented level of global leadership, awareness and support to respond to the HIV/AIDS crisis. A Declaration of Commitment adopted at the Special Session specifies time-bound goals and targets to measure progress and to ensure accountability.

In the Declaration, governments determined that, together with partners, they would: Reduce the proportion of infants infected with HIV by 20 per cent by 2005, and by 50 per cent by 2010.

WHO/UNAIDS/UNICEF infant feeding guidelines >>>