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Adapted from

:
WHO IYCF Counseling :An Integrated Course
17/1

Overview of HIV and infant feeding

After completing this session participants
will be able to:
• explain the risk of mother-to-child transmission of HIV
• describe factors which influence mother-to-child
transmission
• outline approaches that can prevent mother-to-child
transmission through safer infant feeding practices
• state infant feeding recommendations for women who
are HIV-positive and for women who are HIV-negative
or do not know their status
17/2

Defining HIV and AIDS

HIV
• Human immunodeficiency virus is the virus
that causes AIDS

AIDS
• Acquired immunodeficiency syndrome is
the active pathological condition that follows
the earlier, non-symptomatic state of being
HIV-positive
17/3

Mother-to-child transmission of HIV

Young children who get HIV are usually
infected through their mother
• during pregnancy across the placenta
• at the time of labour and birth through blood
and secretions
• through breastfeeding

This is called mother-to-child transmission
of HIV or MTCT
17/4
Estimated risk and timing of mother-to-
child transmission of HIV in the absence
of interventions

Timing of MTCT of HIV Transmission Rate
• During pregnancy 5-10%
• During labour and delivery 10-15%
• During breastfeeding 5-20%
_______________________________________________________________________________________________________

• Overall without breastfeeding 15-25%
• Overall with breastfeeding to 6 months 20-35%
• Overall with breastfeeding to 18–24 months 30-45%
17/5

100 mothers and babies
100 mothers and babies

Assume prevalence of HIV infection among women is 20 %

Q. How many of these women are likely to be HIV-positive ?
17/6

100 mothers and babies

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100 mothers and babies

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100 mothers and babies

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17/9

100 mothers and babies
17/10

20 babies
17/11

20 babies
17/12

20 babies
17/13

Factors which affect mother-to-child
transmission of HIV

• Recent infection with HIV
• Severity of disease
• Sexually transmitted infections
• Obstetric procedures
• Duration of breastfeeding
• Exclusive breastfeeding or mixed feeding
• Condition of the breasts
• Condition of the baby’s mouth
17/14

Policy of supporting breastfeeding

“As a general principle, in all populations,
irrespective of HIV infection rates,
breastfeeding should continue to be
protected, promoted and supported.”

HIV and Infant Feeding: a policy statement, developed
collaboratively by UNAIDS, WHO and UNICEF, 1997.
17/15

Infant feeding recommendations
for HIV-positive women

• When replacement feeding is acceptable,
feasible, affordable, sustainable and safe,
avoidance of all breastfeeding by HIV-
infected mothers is recommended

• Otherwise, exclusive breastfeeding is
recommended during the first months of life
17/5

1000 mothers and babies
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1000 mothers and babies