Infant Feeding and HIV
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DRAFT PRESS RELEASE, 27 April, 1998
UNICEF, WHO, UNAIDS announce consensus on Infant Feeding and HIV
In a concerted effort to stop the spread of HIV/AIDS among young chil-
dren and mothers, the UNAIDS program and two of its co-sponsors have
supported the use of alternatives to breast-feeding for infants born to
HIV positive women. The World Health Organisation (WHO), the United Na-
tions Children's Fund (UNICEF) and the Joint UN Programme on HIV/AIDS
(UNAIDS) has endorsed the implementation of new guidelines on HIV and
infant feeding. The guidelines were the product of a meeting and fur-
ther discussions which took place in Geneva recently.
The guidelines are intended to help governments devise national poli-
cies to fight the spread of HIV/AIDS and to assist health care managers
in providing appropriate services and support. The guidelines stress
the importance of protecting, promoting and supporting breast-feeding
as the best method of feeding for infants whose mothers are HIV-
negative or who do not know their HIV status. But at the same time,
they recognise the need to support alternatives to breast-feeding for
mothers who test positive for the human immuno-deficiency virus that
causes AIDS.
Participants at the meeting emphasised the need to support HIV-positive
mothers in their right to choose an infant feeding method appropriate
to their needs. They stressed that those mothers who decide not to
breast-feed their children must be ensured access to sufficient quanti-
ties of nutritionally adequate breast-milk substitutes. They also
agreed there is an urgent need for the resources and information re-
quired to enable women to prepare these replacements as safely as pos-
sible.
"These guidelines bring together two important goals: reducing mother-
to-child HIV transmission, and affirming the benefits of breast-
feeding, which is the optimal source of nutrition for most infants"
said Dr Tomris Tuermen, Executive Director, Family and Reproductive
Health, WHO.
The participants included government officials responsible for maternal
and child health, nutrition and HIV/AIDS programmes as well as repre-
sentatives of non-governmental organisations, the infant feeding indus-
try, and scientists with expertise in infant feeding and HIV/AIDS.
Three Million Children Infected World-wide
HIV can be transmitted from an infected mother to her child: children
born to HIV positive mothers have a one-in-three chance of contracting
the virus. Of these, one-third become infected by breast-milk, with the
other two-thirds infected in utero or during birth.
To date, 3 million children world-wide have been infected with HIV, and
the rapid and accelerating spread of the disease world-wide has rein-
forced predictions that HIV/AIDS is becoming a major killer of chil-
dren, especially in the developing world. In 1997 alone, more than half
a million children were infected globally.
Offering a Solution
Recent results from a study conducted in Thailand among non-breast-fed
infants showed a 50 per cent reduction in mother-child transmission
with a short-course regimen of the antiretroviral drug AZT during preg-
nancy and childbirth. Participants at a meeting convened by UNAIDS in
March 1998, reviewed issues related to the implementation of effective
interventions in developing countries, particularly those involving the
short course AZT regimen.
In addition to the key recommendation of increasing access to alterna-
tives to breast feeding for HIV positive women, the HIV infant feeding
guidelines emphasise the need to improve access to voluntary and confi-
dential HIV counselling and testing, particularly for pregnant women as
well as proper infant feeding counselling.
The participants also endorsed the need to implement measures to pre-
vent breast-feeding from being undermined among HIV negative women and
among those whose HIV status is unknown. There was a consensus that
methods for procuring, distributing and making available replacements
for breast-milk must comply with the International Code of Marketing of
Breast-milk Substitutes, and subsequent resolutions of the World Health
Assembly.
Health care services, especially in developing countries, were also a
priority on the meeting agenda. There was a focus on the need to
strengthen health services, particularly reproductive and child health
services, to implement interventions that would reduce HIV infection in
women and reduce mother to child transmission of HIV, and to ensure
care and social support for HIV positive mothers and their children.
Working Together to Prevent HIV/AIDS
Professor Fred Sai, the Chair of the meeting, pointed out that "WHO and
UNICEF are committed to working together with UNAIDS and its partners
to take concrete action to prevent mother to child transmission of HIV
infection. They know that HIV positive women and their families must
receive the care and support they need."
As a result of a consensus at both the March and April meetings, a
working group will be established to facilitate and support accelerated
action on the part of the United Nations agencies and organisations,
UNAIDS and others. This working group will move as quickly as possible
to implement interventions to reduce mother-to-child transmission, in-
cluding adequate infant feeding alternatives.
For more information, please contact (UNAIDS info)(WHO info)(UNICEF
info)
--
Dr Erik van Praag
mailto:vanpraage@who.ch
--
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