Maternal, newborn, child and adolescent health

HIV and other infant feeding policies, programmes and practices

Q.24 The recommendations say that mothers should breastfeed for 12 months. Can a national authority recommend longer than this?

Yes. The guidelines state that 12 months of breastfeeding with ARVs is the time period which will give most benefit to infants in countries where the burden of HIV is high. However, there may be circumstances in some countries or specific regions of a country which may lead national authorities to extend the recommended period of breastfeeding beyond 12 months.

Where women cannot safely provide foods to replace breast milk after 12 months, then national authorities can specify a different duration of breastfeeding, and provide ARVs over this longer time. Health workers need to provide a consistent message and ensure that the supply chain to provide ARVs over an extended period operates effectively. Other circumstances when it may be appropriate to recommend HIV-infected mothers to breastfeed for longer than 12 months may include an emergency, such as an earthquake, drought or conflict, or a region with very high infant mortality and/or limited health services. (See also Q72)

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