Infant feeding policy debated at the Conference on Retroviruses and Opportunistic Infections

One of the most discussed topics at the Conference on Retroviruses and Opportunistic Infections in Los Angeles 26th February to 4th March 2007 was how HIV-infected mothers can safely feed their infants in resource-limited settings.

Should public health programmes in resource-limited settings encourage mothers with HIV to avoid breastfeeding or does this cause more harm than good? Should infant feeding decisions be made on a case-by-case basis, or would a public health approach unambiguously in favour of exclusive breastfeeding — and against early weaning — cause less confusion and lead to better outcomes? Could the increased morbidity and mortality and decreased HIV-free survival actually be associated with the abruptness of weaning, rather than the timing of early cessation?

Although WHO/UNICEF’s Global Strategy for Infant and Young Child Feeding had already been revised in advance of the new data presented during the conference, questions remain as to the full implications of the recent reports and how, exactly, programmes in different resource-limited settings should be adapted to best provide support to mothers with HIV. Some experts believe that an individualised approach for each mother’s infant feeding decisions is necessary, while others believe that women in most resource-constained settigns should no longer be advised to avoid breastfeeding or wean early.

The key reports and related studies, information on WHO’s emphasis on the mother’s individual circumstances, and making exclusive breastfeeding AFASS, see:

Infant feeding policy debated at the Conference on Retroviruses and Opportunistic Infections.doc