Presentation on theme: "Dr KANUPRIYA CHATURVEDI Dr. S.K. CHATURVEDI"— Presentation transcript:
1Dr KANUPRIYA CHATURVEDI Dr. S.K. CHATURVEDI INFANT FEEDING AND HIVDr KANUPRIYA CHATURVEDIDr. S.K. CHATURVEDI
2Lesson ObjectivesUnderstand the current global recommendations for infant feeding in context of HIV/AIDS.Understand importance of optimal infant and young child feeding for child health, nutrition, growth, and development.Define main options for infant feeding and benefits and risks.Describe steps for counselling HIV-positive mothers about infant feeding.Understand importance of postnatal follow-up and support in infant feeding.
3Introduction to Infant Feeding ARV prophylaxis administered to the mother and infant reduces MTCTUp to 20% of infants breastfed by HIV-infected mothers are at risk of acquiring HIVNational and UN infant- feeding recommendations and guidelines can reduce MTCT
4Infant Feeding and Child Survival World Health Report (2002)Malnutrition is an underlying cause of 60% of deaths in children under 5 yearsBeing underweight was associated with 3.7 million deaths in 2000Poor feeding practices causing malnutrition and diarrhoea are a major cause of death in children
5Infant Feeding and Child Survival (contd.) Counselling and support of infant feedingImproves feeding practicesPrevents malnutritionPrevents HIV transmission to infantsReduces the risk of death in children
6Infant Feeding: HIV-Negative Mothers UN RecommendationsExclusive breastfeeding for 6 monthsBreastfeeding continued for 2 years or beyondIntroduction of nutritionally adequate and safe complementary foods after 6 monthsInformation to mothers about the risk of HIV-infection late in pregnancy or during breastfeeding
7Exclusive Breastfeeding DefinitionGiving an infant only breast milk, with the exception of drops or syrups consisting of vitamins, mineral supplements, or drugsNo food or drink other than breast milk, not even water
8Infant Feeding: HIV-Positive Mothers WHO RecommendationsAvoid all breastfeeding if replacement feeding is :AcceptableFeasibleAffordableSustainable &SafeOtherwise, exclusive breastfeeding during the first months of life
9Breast-milk Feeding Options: Exclusive Breastfeeding AdvantagesEasily digestibleNutritious and completeAlways availableNo special preparation neededProtects from diarrhoea, pneumonia, and other infections/diseasesPromotes bondingDisadvantagesRisk of passing HIV to babyRequires feeding on demandMother requires additional calories to support breastfeeding
10Guidelines for the Community Ensure all HIV-infected mothers receive feeding counsellingIdentify the range of feeding options that are acceptable, feasible, affordable, sustainable, and safeEducate the public about MTCTTrain infant-feeding counsellorsTrain peer counsellorsSupport the mother’s choice
11Breast-milk Feeding Options: Exclusive Breastfeeding with Early Cessation Advantage• Terminates infant’s exposure to HIVDisadvantages• Breast-milk substitute is necessary• Mother's breasts may become engorged• Mother at risk of becoming pregnant if sexually active
12Expressed Heat-treated Breast Milk Steps for breast milk preparationWash all containers with soap and waterHeat enough expressed milk for one feedHeat to boiling and coolUse within one hour
13Replacement Feeding Options: Commercial Infant Formula Advantages• No risk of transmitting HIV• Made especially for infants• Includes most nutrients an infant needs• Others can feed infantDisadvantages• Infant is more likely to get sick• Need reliable formula supply• Formula is expensive• Requires clean water• Must be made fresh each time• Infant needs to drink from a cup• Not breastfeeding may raise questions about mother’s HIV status
14Replacement Feeding Options: Home-Prepared Modified Animal Milk Disadvantages• Infant more likely to get sick• Must be made fresh each time• Difficult to digest• Multivitamin supplements needed• Must add boiled water and sugar• Mother must stop breastfeeding• Does not contain antibodies• Infant needs to drink from a cup• Not breastfeeding may raise questions about mother’s HIV statusAdvantages• No risk of transmitting HIV• Less expensive than commercial formula• Can be used when commercial infant formula runs out• Others can feed infant
15Infant-Feeding Counselling and Support Infant-feeding counselling, education, and support shouldBe provided before and after birthBe based on national protocolBe based on a woman’s circumstancesInclude information on infant-feeding options and advantages and disadvantagesProvide women with safer feeding skillsInclude demonstrations or opportunities to practiceEncourage partner or family involvementProvide disclosure support
16Infant-Feeding Counselling and Support Counselling VisitsAt least one during the antenatal periodImmediately after birthWithin 7 days of birth to monitor post-partum and infant-feeding progressMonthly follow-up sessionsAdditional sessions may be required during high-risk time periods
17Infant-Feeding Counselling and Support Infant-Feeding Counselling StepsSTEP 1: Explain risks of MTCTSTEP 2: Explain advantages and disadvantages of different feeding options, starting with mother’s initial preferenceSTEP 3: Explore mother’s home and family situationSTEP 4: Help mother choose an appropriate option
18Infant-Feeding Counselling and Support Infant-Feeding Counselling Steps (continued)STEP 5: Demonstrate how to practice chosen feeding optionReplacement feedingExclusive breastfeedingOther breast milk optionsSTEP 6: Provide follow-up counselling and support
19Summary HIV transmission risk continues if child is breastfed. HIV-infected women, and those with unknown status, need infant-feeding counselling and support.The mother has the right to choose how she wants to feed her infant, and the healthcare worker’s job to support this choice.
20SummaryHIV-infected mothers should avoid breastfeeding when replacement feeding is acceptable, feasible, affordable, sustainable, and safe.If breastfeeding is chosen option, exclusive breastfeeding with early cessation is appropriate at or before 6 months.
21SummaryCounselling, education, and support help establish and maintain safe infant-feeding practices.Prevent misuse of replacement feeding.Promote exclusive breastfeeding for general population.Discourage use of replacement milk supplies by mothers whose infants don’t need them.