12.6  Strategies to decrease transmission of HIV during breastfeeding

You have learned that the preferred infant feeding option in the context of maternal HIV is to support mothers to breastfeed exclusively for the first six months. Every effort should be made to decrease the chance of transmission of HIV from the mother to the child.

The following list shows some of the strategies that may help to decrease the possibility of transmission:

• Expand ANC services and universal access to antenatal prevention of mother-to-child transmission (PMCT) services
• Actively support exclusive breastfeeding from birth until six months
• Advise parents not to mix feeds, advise them never offer other liquids, milks or foods in addition to breastmilk in the first six months, as this irritates the baby’s gut and may lead to a higher rate of virus transmission to the infant
• Promote good health and nutrition of the mother
• Advise mothers to maintain good breast health and seek immediate attention for cracked nipples, mastitis or abscesses
• Support mothers to avoid becoming infected with HIV during breastfeeding (counsel on safe sex)
• Promote and support the initiation of complementary feeding at six months and to continue breastfeeding until the child is 12–18 months.

As a Health Extension Practitioner you have an important role in these strategies. You can use your knowledge and your skills in counselling to advise mothers (and families) on the best feeding options for infants born to HIV-positive mothers in order to optimise the health and development of the infant.