Battle to change infant feeding for HIV-positive mothers in South Africa.
Article Type: Brief article
Subject: HIV seropositivity (Care and treatment)
Breast feeding (Safety and security measures)
HIV infection in children (Risk factors)
HIV infection in children (Prevention)
Antiviral agents (Dosage and administration)
Pub Date: 05/01/2010
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2010 Source Volume: 18 Source Issue: 35
Topic: Event Code: 260 General services
Organization: Organization: World Health Organization
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 236247770
Full Text: Since November 2009, WHO recommends that HIV-positive mothers or their infants take antiretroviral drugs throughout breastfeeding, and that the child can benefit from breastfeeding with very little risk of HIV infection. In spite of this, it is a challenge to change the ingrained culture of formula feeding in South Africa, which has been influenced by the high HIV prevalence. Health workers are not convinced of the benefits of breastfeeding, and some are confused about the correct practice regarding HIV. They often lack the skills to offer support and advice on breastfeeding so when problems arise such as cracked nipples, mothers become discouraged and stop breastfeeding. Most children born to HIV-positive mothers and raised on formula do not die of AIDS but of undernourishment, diarrhoea, pneumonia and other causes not related to HIV, and breastfeeding helps protect against these. The greatest declines in breastfeeding have happened in countries such as South Africa where formula milk has been distributed at no cost with "strong and dishonest" marketing campaigns claiming that formula milk is superior to breastmilk. Breastfeeding is also a problem for women who go back to work and cannot fit breastfeeding in, and others feel it is an inconvenience. This article says the government needs to communicate the message that breastfeeding is good, and convince industry to make it easy for mothers to carry on breastfeeding after returning to work. Advocacy should be directed at society as a whole, and health workers must have a basic understanding of the current research so that they can give correct information. (1)

(1.) Langa L. Breast is always best, even for HIV-positive mothers. Bulletin of World Health Organiztion 2010;88:9-10.
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