e-Library of Evidence for Nutrition Actions (eLENA)

Infant feeding for the prevention of mother-to-child transmission of HIV

Mother-to-child transmission of HIV is the primary mode of HIV infection in infants. Transmission can occur during pregnancy, birth, or through breastfeeding. Decisions on whether or not HIV-infected mothers should breastfeed their infants is generally based on comparing the risk of infants acquiring HIV through breastfeeding, with the increased risk of death from malnutrition, diarrhoea and pneumonia if the infants are not exclusively breastfed.

Accumulating evidence has shown that giving antiretroviral medicines to the mother or the infant can significantly reduce the risk of HIV transmission through breastfeeding. National health authorities can refer to this evidence when formulating a strategy on infant feeding.

WHO recommendations

Mothers known to be HIV-infected should be provided with lifelong antiretroviral therapy or antiretroviral prophylaxis interventions to reduce HIV transmission through breastfeeding.

National or sub-national health authorities should decide whether health services will principally counsel mothers known to be HIV-infected to either breastfeed and take antiretrovirals, or, avoid all breastfeeding.

In settings where national health authorities are recommending breastfeeding for HIV-infected mothers:

Mothers known to be HIV-infected (and whose infants are HIV uninfected or of unknown HIV status) should exclusively breastfeed their infants for the first 6 months of life, introducing appropriate complementary foods thereafter, and continue breast feeding for the first 12 months of life.

Breastfeeding should then only stop once a nutritionally adequate and safe diet without breast milk can be provided.


This is a summary of WHO recommendations. The full set of recommendations can be found in the guidelines and guidance documents, under ‘WHO documents’ below.

WHO documents


GRC-approved guidelines
Other guidance documents

Evidence


Systematic reviews used to develop guidelines
Related Cochrane reviews
Clinical trials
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Last update:

13 November 2014 14:20 CET

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee

Essential Nutrition Actions

This intervention is supported by Essential Nutrition Actions targeting the first 1000 days of life.