HIV and infant feeding: UN agencies agree on a framework for priority action: one conclusion from ICASA, Nairobi: helping mothers who are HIV-positive 'to select and sustain the best feeding option' is a key role for midwives.

A 'glance' at the HIV/AIDS situation in Africa

Delegates were reminded of the up-to-date facts relating to the spread of the disease. In the global context of over 40 million people infected with HIV:

* An estimated 29 million people are infected with HIV in sub-Saharan Africa.

* An estimated 12 million AIDS orphans exist in Africa

* According to an on-going World Health Organisation study, HIV prevalence in West African countries ranges from 0.5% (Senegal) to 11%.

* South African countries have the greatest prevalence rates. In Botswana and Lesotho, prevalence rates are over 30%.

HIV and Infant Feeding Framework for Priority Action

The conference saw the launch of an important new document on infant feeding, which is backed by all the UN agencies concerned with health and food. The framework for action has been described by the World Alliance for Breastfeeding Action as 'breast feeding-friendly' and as a summary of advice on 'how to go to scale with programs to prevent ... HIV transmission through breastfeeding'.

The document begins with the facts:

Risk of HIV infection in infants and young children

There are increasing numbers of children injected with HIV, especially in the countries most affected by the epidemic. In 2002, an estimated 3.2 million children under 15 years of age were living with HIV/AIDS, a total of 800,o00 were newly infected and 610,000 died

The overwhelming source of HIV injection in young children is mother-to-child transmission. The vines may be transmitted during pregnancy, labour and delivery, or by breastfeeding ...

Rates of mother-to-child transmission range from 14-25% in developed and from 13-42% in other countries. It is estimated that 5-20% of infants born to HIV-positive women acquire infection through breastfeeding ...

Health risks for non-breastfed infants

The risks associated with not breastfeeding vary according to the environment [and] the individual circumstances of the mother and her family, including her education and economic status ...

Lack of breastfeeding compared to any breastfeeding has been shown to expose children to increased risk of malnutrition and life-threatening infectious diseases other than HIV, especially in the first year of life, and exclusive breastfeeding appears to offer greater protection against disease than any breastfeeding. This is especially the case in developing countries where 54% of all under-five deaths are associated with malnutrition. Not breastfeeding during the...

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