UNICEF Policy on Infant feeding and HIV
- UNICEF and other UN agencies recommend exclusive breastfeeding for HIV-infected women for the first six months of life unless replacement feeding is acceptable, feasible, affordable, sustainable and safe before that time. Such conditions are rare in much of the developing world. However, if they do exist, it is recommended that HIV-infected women avoid breastfeeding.
- If all HIV-positive untreated women breastfeed, most of their children – approximately 80 per cent -- will not contract HIV through breastmilk. However, 5-20 per cent could contract the virus. There is a risk.
- Therefore, the most appropriate infant feeding option for an HIV-infected mother depends on her individual circumstances. She must have the information she needs to make an informed decision and all the services and support to help her implement that decision.
- If formula feeding is still not acceptable, feasible, affordable, sustainable and safe at the age of six months, continuation of breastfeeding with additional complementary foods is recommended along with regular assessment of both mother and baby. Breastfeeding should stop once a nutritionally adequate and safe diet without breastmilk can be provided.
- Breastfeeding mothers of infants and young children who are known to be HIV-infected should be strongly encouraged to continue breastfeeding.
- Whether the child is breast or formula fed, health services should monitor all HIV-exposed infants and offer infant feeding counselling and support, particularly at key moments such as the diagnosis of the HIV status of the infant and at six months of age, when complementary feeding can begin.
- Governments and other stakeholders should promote and support breastfeeding in the wider community. They should offer active support to HIV-infected mothers who choose to exclusively breastfeed and take measures to make formula feeding safer for HIV-infected women who choose that option.
- National programmes should provide all HIV-exposed infants and their mothers with a full package of health-related interventions, with strong links to HIV prevention, treatment and care services. Health services should make every effort to protect children who test negative for HIV after delivery from infection, particularly during breastfeeding.
- Governments and donors should greatly increase their commitment and ability to implement the Global Strategy for Infant and Young Child Feeding and the UN HIV and Infant Feeding Framework for Priority Action. Together these strategies seek to prevent post-natal HIV infections, improve overall child survival rates and move the world closer to achieving the health-related MDGs.
- Knowing one’s HIV status is crucial to making choices about feeding, so voluntary and confidential testing is a priority. However, the most important means of preventing mother to child transmission is basic HIV education. Efforts to protect young mothers from infection are critical, and UNICEF supports a wide range of education programmes at the local level to educate women and girls of the risks.