Infant feeding advice for women who do not have regular access to antiretroviral drugs

Infant feeding advice for women who do not have regular access to antiretroviral drugs

In situations where health services cannot supply women or infants with a regular supply of antiretroviral drugs, for an extended period of time, women are recommended to exclusive breastfeed for the first 6 months of an infant's life and rapidly wean to avoid mixed feeding. Mixed feeding is not recommend because studies suggest it carries a higher risk than exclusive breastfeeding. Potentially this is because it damages the lining of the baby's stomach and intestines thus making it easier for HIV in breast milk to infect the baby. If a HIV positive mother does not have access to ARVs she is strongly recommended to rapidly wean. Unfortunately, the best duration for this is not yet known and may vary according to the infant's age and/or the environment ^{19 20}.

Read more about HIV and breastfeeding.

Caesarean sections

A caesarean section is an operation to deliver a baby through its mother's abdominal wall. When a mother is HIV positive a caesarean section may be done to protect the baby from direct contact with her blood and other bodily fluids. However, as with formula feeding, there is a need to weigh the risk of HIV transmission against the risk of harm due to the intervention.

If the mother is taking combination antiretroviral therapy then a caesarean section will often not be recommended because the risk of HIV transmission will already be very low. Caesarean delivery may be recommended if the mother has a high level of HIV in her blood, but the procedure is seldom available and/or safe in resource poor settings.