As you read earlier, breastfeeding has unsurpassed advantages over any other form of infant feeding. In resource-limited countries such as Ethiopia, breastfeeding is an essential component of child survival interventions. Infant mortality is higher in settings where infants are not breastfed or breastfeed for a short time only (that is, less than six months).

Although breastfeeding by an HIV-positive mother can transmit the virus to the infant, replacement feeding, if not instituted correctly, is associated with increased risk of morbidity and mortality at a young age in low resource settings like Ethiopia. Exclusive breastfeeding (EBF) during the first six months of life is associated with decreased transmission of HIV and improved child survival compared with non-exclusive breastfeeding. Because of high infant mortality rates in Ethiopia, EBF for as long as possible up to six months is recommended as the only feasible and the safest option for infant feeding amongst HIV-infected women.

At six months, complementary foods should be introduced to sustain healthy growth. Most Ethiopian children will continue to benefit from breastfeeding until 12-18 months of age. Universal access to antenatal and postnatal prevention of mother-to-child HIV transmission (PMTCT) services and prioritising antiretroviral therapy for eligible pregnant and lactating women is an important part of decreasing perinatal transmission of HIV.

When the infant reaches six months, you should advise the mother to add a complementary feeding in addition to the breastfeeding until the child reaches 12-18 months. Breastfeeding should stop only when a nutritionally adequate diet without breast milk can be provided. This is usually around 12-18 months of age. Infants who are known to be HIV infected should continue to breastfeed according to recommendations for the general population. Mothers can give replacement feeding either exclusively, or they can provide in addition to breast milk. The aim of feeding replacement food in HIV-positive mothers are to reduce the chance of HIV transmission from the mother to the newborn through breast milk but, currently, exclusive breastfeeding is recommended over replacement feeding for HIV positive mothers due to increased morbidity and mortality rate of infants.

Last modified: Wednesday, 1 March 2017, 2:10 AM