An Overview of HIV and Breastfeeding can be found here.
Published by UNAIDS
The number of infants born with HIV infection is growing every day. The AIDS pandemic represents a tragic setback in the progress made on child welfare and survival. Given the vital importance of breast milk and breast- feeding for child health, the increasing prevalence of HIV infection around the world, and the evidence of a risk of HIV transmission through breast-feeding, it is now crucial that policies be developed on HIV infection and infant feeding. The following statement provides policy-makers with a number of key elements for the formulation of such policies.
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Produced by the Yezingane Network and UNICEF December 2010, updated July 2011
Abstract: This booklet presents the new evidence on the importance of breastfeeding in the context of HIV in an easy-to-understand way.
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Published by the Yezinga Network December 2010
This handbook, produced by the Yezingane Network and the United Nations Children's Fund, UNICEF, is designed to answer frequently asked questions (FAQs) about infant feeding in the context of HIV. Beginning with the World Health Organization (WHO) definition of exclusive breastfeeding (giving the baby no food or drink - not even water - other than breastmilk), the FAQs section provides basic information about breastfeeding and breastfeeding with HIV through answers
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The road to elimination of new HIV infections among children
With the right programs and financing, the UN and its partners have said that, by 2015, virtually no HIV-positive mother will have to pass along HIV to her newborn — an exciting goal that can be achieved in just a few short years.
This infographic describes the UNAIDS plan to eliminate PMTCT by 2015 by several programmes.
Download this infographic here (PDF, 864.02KB, 1pg)
Principles and recommendations for infant feeding in the context of HIV and a summary of evidence.
Published by WHO 2010
ISBN: 9789241599535
Significant programmatic experience and research evidence regarding HIV and infant feeding have accumulated since WHO's recommendations on infant feeding in the context of HIV were last revised in 2006. In particular, evidence has been reported that antiretroviral (ARV) interventions to either the HIV-infected mother or HIV-exposed infant can significantly reduce the risk of postnatal transmission of HIV through breastfeeding. This evidence has major implications for how women living with HIV might feed their infants, and how health workers should counsel these mothers. Together, breastfeeding and ARV intervention have the potential to significantly improve infants' chances of surviving while remaining HIV uninfected.
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Authors: World Health Organization
Number of pages: 28
Publication date: 2009
Languages: English
ISBN: 9789241598873
On 30 November, the eve of World AIDS Day, the WHO released new recommendations on treatment, prevention and infant feeding in the context of HIV, based on the latest scientific evidence.
The new recommendations call for earlier initiation of antiretroviral therapy (ART) for adults and adolescents, the delivery of more patient-friendly antiretroviral drugs (ARVs), and prolonged use of ARVs to reduce the risk of mother-to-child transmission of HIV. And, for the first time, WHO recommends that HIV-positive mothers or their infants take ARVs while breastfeeding to prevent
Download rapid advice here (30p., 267 KB)
Nutrition News for Africa
Background
Additional research and programmatic evidence has accumulated regarding HIV/AIDS treatment and care since the World Health Organization (WHO) last revised its recommendations on infant feeding in the context of HIV in 2006. In particular, new studies have found that antiretroviral (ARV) treatment provided to either the HIV-infected mother or the HIV-exposed infant can substantially reduce the risk of post-natal transmission of HIV through breastfeeding. Because of the importance of these findings for national HIV treatment and infant feeding guidelines, WHO has just released three rapid advice recommendations concerning these issues. The specific topics covered are: 1) antiretroviral therapy (ART) for HIV infection in adolescents and adults; 2) the use of ART for treating pregnant women and preventing HIV Infection in infants; and 3) the principles and recommendations on infant feeding in the context of HIV. Readers are encouraged to obtain all three rapid advice recommendations at: http://www.who.int/hiv/en/.
The current issue of NNA summarizes the new WHO recommendations regarding infant feeding in the context of HIV.
Summary of Recommendations
A total of 8 key principles and 7 key recommendations were developed for the new set of WHO guidelines. These principles and recommendations are directed towards policy makers, academics, and health workers; and they are intended to assist national technical groups and international partners in formulating infant feeding recommendations in the context of HIV. The principles reflect a set of values regarding the provision of care; and the most important key principle is that infant feeding practices by mothers known to be HIV-infected should support the greatest likelihood of HIV-free survival of their children and not harm the health of mothers. This principle is meant to balance the risk of infants acquiring HIV through breast milk with the higher risk of dying from other causes, such as diarrhea and lower respiratory tract infections, due to the elevated risk of these non-HIV related diseases among infants who are not breastfed.
The 7 key recommendations are summarized, as follows:
1. HIV-infected mothers should be provided with lifelong ART's or antiretroviral prophylaxis interventions to reduce HIV transmission through breast milk. (The specific recommendations on the use of anti-retroviral drugs for treating pregnant women and preventing transmission of HIV infection to infants can be found at: http://www.who.int/hiv/topics/mtct/. Briefly, to prevent HIV transmission to infants via breastfeeding, either: 1) the mother should receive AZT during pregnancy, and the infant should receive daily Nevirapine from birth until the cessation of breastfeeding; or 2) the mother should receive a 3-drug regimen during pregnancy, and this maternal regimen should be continued until the cessation of breastfeeding.)
2. HIV-infected mothers with uninfected infants (or infants with unknown HIV status) should exclusively breastfeed for the first 6-months, after which appropriate complementary foods should be introduced. Breastfeeding should be continued through 12 months of life, and should be stopped only after nutritionally adequate and safe dietary alternatives can be provided.
3. Abruptly stopping breastfeeding is not advisable. HIV-infected mothers who decide to stop breastfeeding should gradually stop over the course of approximately one month. If the mother or child has been taking prophylaxis medications, this treatment should continue for at least one week after stopping breastfeeding.
4. Infants of HIV-infected mothers who stop breastfeeding should be provided with safe and adequate replacement feeds to enable normal growth.
5. HIV-infected mothers with uninfected infants (or infants with unknown HIV status) should only provide commercial infant formula milk as a breast milk replacement if the milk replacement is: affordable, feasible, acceptable, sustainable, and safe (AFASS).
6. HIV-infected mothers should consider expressing and heat-treating breast milk as an interim strategy in special circumstances, to assist with stopping breastfeeding, or if ART is temporarily unavailable.
7. HIV-infected infants and young children should be exclusively breastfed for the first 6-months of life, and continue breastfeeding up to 2-years or beyond.
Program Implications
New evidence indicating that provision of ART to either HIV-infected mothers or HIV-exposed infants can markedly reduce or eliminate HIV transmission through breast milk has major implications for infant and young child feeding recommendations. The specifically recommended ART regimens are described on the WHO web site indicated above. If these recommendations are effectively implemented, they should yield improvements in the quality of life and survival of women living with HIV and important reductions in HIV transmission and deaths due to HIV/AIDS and other causes in young children.
Editorial Comments*
Since the late 1980's it has been known that exclusive breastfeeding of non-HIV exposed infants decreases the incidence of diarrhea and pneumonia and reduces infant mortality; and ongoing breast feeding beyond six months continues to reduce these risks, even into the second year of life. However, infant feeding studies in the context of HIV have indicated that mother-to-child-transmission of HIV (MTCT) can occur via breast milk. As a result, earlier recommendations in settings with high HIV prevalence emphasized the use of replacement feeds when AFASS, to avoid the risk of MTCT of HIV. However, newer data have since shown that children who receive replacement feeds are at greater risk of other (non-HIV) infections and death. Therefore, when developing infant feeding recommendations in the context of HIV, both the risk of HIV transmission and the risk of death from other causes must be considered.
For these reasons, the new WHO infant feeding recommendations aim to maximize HIV-free survival time. Because the latest studies show that the risk MTCT of HIV via breast milk can be reduced or eliminated if the mother and/or child are given ART, it is now possible to recommend usual breast feeding practices in most cases, as with children of HIV-negative mothers.
* These comments have been added by the editorial team and are not part of the cited publication.
For pregnant women and their families
Published by the Yezingane Network June 2010
Brief 10
This briefing document contains up-to-date information on preventing HIV infection in babies. This information can help pregnant women and their families as well as people providing services to pregnant women, and organisations advocating for improved services. Please share this information with others – it can save lives.
View Preventing Mother-To-Child Transmission of HIV (PMTCT) attached below (PDF, 656,51KB, 4pg)
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World Health Organisation. The present document presents guidelines for feeding non-breastfed children after the first six months of life. Download (616 KB).
From SA Dept of Health document "Prevention of Mother-to-Child HIV Transmission and Management of HIV Positive Pregnant Women" launched October 2000.
4.1 Maternal Factors
4.2 Behavioural factors
4.3 Obstetrical Factors
4.4 Infant Factors
4.5 Viral Factors
Read the document online