Review the guidelines pertaining to infant feeding and HIV from the World Health

Question

Review the guidelines pertaining to infant feeding and HIV from the World Health Organization (Recommendation 5 below). Consider the implications of these guidelines for a low resource setting with a high HIV prevalence e.g. a country like Malawi or Zambia.

My question is this:
a) Explain what this recommendation is recommending.


The recommendation is below:
Conditions needed to safely formula feed:

Mothers known to be HIV-infected should only give commercial infant formula milk as a replacement feed to their HIV-uninfected infants or infants who are of unknown HIV status, when specific conditions are met:

a. safe water and sanitation are assured at the household level and in the community; and

b. the mother, or other caregiver can reliably provide sufficient infant formula milk to support normal growth and development of the infant; and

c. the mother or caregiver can prepare it cleanly and frequently enough so that it is safe and carries a low risk of diarrhoea and malnutrition; and

d. the mother or caregiver can, in the first six months, exclusively give infant formula milk; and

e. the family is supportive of this practice; and

f. the mother or caregiver can access health care that offers comprehensive child health services.

(Strong recommendation, low quality of evidence)

Explanation / Answer

When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended. It should only be done when mothers in countries like Malawi can and will provide it for the first six months of the baby's life.

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