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

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.

Mothers living with HIV should breastfeed for at least 12 months and may continue breastfeeding for up to 24 months or longer (similar to the general population) while being fully supported for ART adherence (see the WHO Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection for interventions to optimize adherence).

In settings where health services provide and support lifelong ART, including adherence counselling, and promote and support breastfeeding among women living with HIV, the duration of breastfeeding should not be restricted.

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

National and local health authorities should actively coordinate and implement services in health facilities and activities in workplaces, communities and homes to protect, promote and support breastfeeding among women living with HIV.

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.