International Bulletin - Fall 1997
HIV and Infant Feeding
Supporting breast-feeding.
As a general principle, in all populations, irrespective of HIV infection rates, breast-feeding should continue to be protected, promoted and supported.
Improving access to HIV counselling and testing
Access to voluntary and confidential HIV counselling and testing should be facilitated for women and men of reproductive age, in part by ensuring a supportive environment that encourages individuals to be informed and counselled about their HIV status rather than one that discourages them out of fear of discrimination or stigmatization.
As part of the counselling process, women and men of reproductive age should be informed of the implications of their HIV status for the health and welfare of their children. Counselling for women who are aware of their HIV status should include the best available information on the benefits of breast-feeding, on the risk of HIV transmission through breast-feeding, and on the risks and possible advantages associated with other methods of infant feeding.
Ensuring informed choice
Because both parents have a responsibility for the health and welfare of their children, and because the infant feeding method chosen has health and financial implications for the entire family, mothers and fathers should be encouraged to reach a decision together on this matter. However, it is mothers who are in the best position to decide whether to breast-feed, particularly when they alone may know their HIV status and wish to exercise their right to keep that information confidential. It is therefore important that women be empowered to make fully informed decisions about infant feeding, and that they be suitably supported in carrying them out. This should include efforts to promote a hygienic environment, essentially clean water and sanitation, that will minimize health risks when a breast-milk substitute is used.
When children born to women living with HIV can be ensured uninterrupted access to nutritionally adequate breast-milk substitutes that are safely prepared and fed to them, they are at less risk of illness and death if they are not breast-fed. However, when these conditions are not fulfilled, in particular in an environment where infectious diseases and malnutrition are the primary causes of death during infancy, artificial feeding substantially increases children's risk of illness and death.
Preventing commercial pressures for artificial feeding
Manufacturers and distributors of products which fall within the scope of the International Code of Marketing of Breast-milk Substitutes (1981) should be reminded of their responsibilities under the Code and continue to take the necessary action to ensure that their conduct at every level conforms to the principles and aim of the code.
Last Modified: June 05, 2010