HIV and other infant feeding policies, programmes and practices
Q.28 How do the new recommendations relate to the International Code of Marketing of Breast-milk Substitutes and subsequent relevant Health Assembly Resolutions?
National implementation of the International Code of Marketing of Breast-milk Substitutes and subsequent relevant Health Assembly Resolutions, and monitoring compliance, is always important. Even in settings where HIV is not highly prevalent, infant feeding is undermined by promotional marketing practices from the food industry and other groups with the result that some mothers, who have every reason to breastfeed, choose not to do so based on misinformation, unfounded fears or lack of confidence in their ability to breastfeed.
The Code provides guidelines on the marketing of breast-milk substitutes, including infant formula and other milk products, foods and drinks, and bottle-fed complementary foods, when they are presented as replacements for breast milk. The Code also includes the marketing of feeding bottles and teats. For countries that have chosen to provide breast-milk substitutes to HIV-infected women, the Code aims to ensure that they are used as safely as possible and, if a national authority decides to provide them to some HIV-exposed infants, that they are distributed under strict controls and only to infants that need them. Conditions should be in place to facilitate safe use, including:
- implementation of the Code at national level, with emphasis on procurement, distribution, correct labelling and packaging of breast-milk substitutes;
- logistic and financial capacity to supply formula without interruption, as long as the child needs it;
- guidelines for health staff regarding who should receive formula, under what conditions, how frequently and for how long, etc.;
- trained infant feeding counsellors; and
- monitoring of health and nutrition status of infants receiving formula.
Where supporting formula feeding is the recommended feeding option, HIV-infected women will need to be helped to properly prepare and give formula1, whether purchased by families or provided by the health authorities. Such support should be given out of view of other women, as provided for in the Code.