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UNICEF welcomes new policy on infant and young child feeding in the context of HIV

UNICEF South Africa/2010
© UNICEF South Africa/2010
This decision to keep mothers and infants on ARV therapy while they breastfeed, will help to reduce the transmission of HIV yet make sure the child benefits from breastmilk and reduce high rates of malnutrition.

2 December 2010, KwaZulu-Natal…UNICEF South Africa today welcomed the decision by the KwaZulu-Natal (KZN) Department of Health to promote breastfeeding for all women, including HIV positive mothers, in line with the latest 2010 World Health Organization (WHO) guidelines relating to HIV and infant feeding. It commended the provincial authority for being the first province to take clear steps to introduce new guidance and counseling to HIV positive mothers to prevent the transmission of HIV to their newborns as well as tackle high rates of malnutrition.

The new policy, in response to these new WHO guidelines, will see the province adopt a new approach to counsel and support breastfeeding for HIV positive mothers, while also making sure mothers and children, regardless of their C4D count receive and continue to take antiretroiviral (ARV) treatment. This decision to keep mothers and infants on ARV therapy while they breastfeed, will help to reduce the transmission of HIV yet make sure the child benefits from breastmilk and reduce high rates of malnutrition.

In the past, the KZN Department of Health provided HIV positive mothers with formula milk to mitigate the risk of transmission of HIV through breastmilk.   Although this may have helped to reduce transmission rates it has contributed to higher rates of malnutrition and diarrhoea, often caused by lack of safe water and poor infant feeding practices. Malnutrition is an underlying cause of 60% of all deaths among children. According to the National Food Consumption survey of 2005, 15% of all children aged between 1 and 9 years in KwaZulu-Natal were stunted, a sign of chronic or long-term malnutrition.
 
“Evidence demonstrates that breastfeeding is one of the best investments in a child’s survival and development.  With the new WHO guidelines becoming operational in KwaZulu-Natal, we can now help HIV positive mothers to prevent transmission of the virus to the child but also reduce high rates of child mortality due to malnutrition, “said Aida Girma, UNICEF South Africa Representative.
 
“This policy shift is in the best interests of the child and promises the greatest public health gain for South African in its efforts to reduce infant mortality.”

This decision also reflects the very strong commitment made by the Premier Dr. Zweli Mkhize to reverse the appalling trends on infant and child mortality in KZN.  Given that South Africa is one of the 12 countries not on track to meet the Millennium Development Goal of reducing under-five mortality, this policy shift could pave the way for genuine progress. Instead of using precious resources on the procurement of formula milk, the Department will ensure pregnant women and their children gain access to ART and ARVs and improve counseling and support for pregnant women and their children.

UNICEF will continue to support the national and other provincial departments of health to ensure that infant feeding with ARV’s is scaled up in the country.

“We are committed to supporting the development of capacity of professional and lay counsellors on HIV and infant feeding in line with the new policy,” said Girma. “We also need to build a partnership with the media and community groups to educate people about these new policies and the benefits for children.

UNICEF is working with the National Department of Health to support the finalization of the Regulations on the Marketing of Breastmilk Substitutes to ensure that mothers and their families are not subjected to wide-scale aggressive marketing practices of formula milk companies. UNICEF will work with the Department to implement this new regulation and monitor the market to ensure compliance. There are also efforts under way to strengthen primary health care centres to make ARV therapy more available and closer to those in need of it.

Key Facts in South Africa:

  • Every hour nearly 9 children die, amounting to 75,000 each year, from causes that could be prevented and/or treated with simple and cost-effective interventions. 
  • In South Africa 30% of all deaths among children aged under-five years occur during the neonatal period, ie about 22,000 newborns die within their first month of life.
  • Breastfeeding is a child survival intervention that is most critical for newborns. It is estimated that 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour (Edmond, K.M. 2006). Breastfeeding-promotion programs need to emphasize early initiation as well as exclusive breastfeeding. This has particular relevance for sub-Saharan Africa, where neonatal and infant mortality rates are high but most women already exclusively or predominantly breastfeed their infants.
  • Malnutrition is an underlying cause of 60% of all deaths among children. According to the National Food Consumption survey of 2005, 15% of all children aged between 1 and 9 years in KwaZulu-natal were stunted ; a sign of chronic or long term malnutrition. The national average in this same study was 18%.

HIV/AIDS is the leading cause of deaths among women and children aged under 5 years

  • AIDS accounts for about 35% of all under-five deaths; and 43.7% of maternal deaths.
  • An estimated 300 000 children are born to HIV-infected women each year, who without interventions an estimated 68 000 will become infected and at least 34, 000 would die.

Read more:

 An AIDS- Free Generation is achievable by focusing on the most disadvantaged communities affected by HIV, says a new U.N. report marking World AIDS Day

 'Children and AIDS: Fifth Stocktaking Report 2010' (PDF)

 Unite for Children, Unite Against AIDS

 How you can help us keep mothers and babies alive

 

 

 

 

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