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If a woman is infected with HIV, there is a risk that she can pass the infection to her infant through breastfeeding. In the first six months, this risk is much greater if the infant is fed both breastmilk and other liquids and foods than if fed breastmilk alone. Therefore, it is recommended that the baby receives breastmilk alone for the first six months, unless it is acceptable, feasible, affordable, sustainable and safe to give breastmilk substitutes (infant formula) exclusively.
HIV testing, treatment and counselling
Pregnant women and new mothers who think they may be infected with HIV should consult a trained health worker for HIV testing and counselling. Women who are HIV-positive should be counselled on how to reduce the risk of passing HIV to their children during pregnancy, childbirth or breastfeeding. They should also be counselled and supported on how to get treatment and care for themselves.
A trained health worker can provide women who are HIV-positive with information on antiretroviral therapy (ART), a group of medicines for people with HIV infection. ART can help reduce the risk of mother-to-child transmission of HIV and contribute to keeping the mother healthy.
All health workers should know if HIV testing and ART are available at their local clinic. They should provide information on these and other related services to pregnant women and new mothers.
Assess the risks and determine what is manageable
The HIV-positive mother should be counselled and provided with information to help her decide which feeding option is best for her baby and most manageable for her. The HIV-positive mother should know that:
The most appropriate infant feeding option for the child of an HIV-infected mother ultimately depends on individual circumstances. The mother needs to assess the risks through discussion with a trained health worker. The mother infected with HIV has the right to: 1) the information she needs to make an informed decision and 2) all the services and support necessary to help her implement that decision.
Infant Feeding Options
The first six months:
After six months:
Other Important Information
During counselling, a pregnant woman or new mother with HIV can be helped to determine whether she can provide her baby with a nutritionally adequate and safe diet without breastmilk. This assessment should be undertaken not only once, such as before the child is born, but also throughout the period of breastfeeding, with the support of the trained health worker.
If the mother is confident that she can provide sufficient amounts of a quality breastmilk substitute, properly and hygienically prepared with clean water, then she can opt to stop all breastfeeding and begin using the breastmilk substitute. A trained health worker should provide the mother and father with guidance on safe and clean practices to prepare the breastmilk substitute.
A new mother who does not know her HIV status should exclusively breastfeed her child for the first six months and continue breastfeeding for up to two years and beyond in addition to feeding the child other nutritious foods and drinks.
Infants confirmed as HIV-positive should be breastfed so they can receive the benefits of breastmilk.