HIV and Infant Feeding: A Chronology of Research and Policy Advances and Their Implications for Programs.

Abstract

Several studies have estimated the contribution of postpartum transmission during breast-feeding to the broader spectrum of mother-to-child transmission which includes transmission before and during delivery. The findings of these studies suggest that HIV can be found in the breast milk of HIV-infected mothers HIV can be transmitted to infants via breast-feeding and mothers who themselves become infected while breast-feeding are at heightened risk of transmitting the virus. The goals of this paper are to 1) review the major advances in the study of HIV and infant feeding and the policy responses to these findings; 2) describe several design and interpretation issues to take into consideration when reading and comparing research studies on this issue; 3) report the findings of several studies and mathematical models which have been developed to guide program and policy recommendations on HIV and infant feeding; 4) summarize what existing studies do and do not reveal about this issue; and 5) recommend areas requiring further research to facilitate adaptation and application of the UNAIDS/UN International Childrens Education Fund/WHO guidelines on HIV and infant feeding. The paper is intended to inform program managers and others who are interested in learning more about HIV and infant feeding but who are not necessarily familiar with all the technical issues in either of these fields.