[pronut-hiv] Nutrition and care for HIV positive infants and children (3)

["Harry Osore" <harryosore@arc-ocean.com>]

 Nutrition and care for HIV positive infants and children (3)
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You are opening a can of worms Lillian! How often  do we talk about
"replacement feeding options", yet in reality, many of these  mothers  do
not have options??? Where  you   introduce an MTCT intervention prior  to
delivery, clearly  you   are compromising any preventions gains achieved as
the risk of MTCT through breastfeeding  among HIV-infected mothers is
approximately 20%. The WHO recommendations is that:When replacement feeding
is acceptable, feasible, sustainable and safe, avoidance of all
breastfeeding by HIV-infected mothers is recommended." Where this is not
feasible, exclusive breastfeeding should be practiced, but the mother's milk
is replaced  completely with other foods when the child completes 3 months
of age (WHO, 2001).This reduces the risk of HIV-infection , but allows the
child to benefit breast milk.

WE  must also remember that exclusive  breast-feeding is not a  common
practice at all!! How many mothers  give water to their kids?? EBF means
only the mother's milk, nothing  else  ( liquid or solid with exception of
drops or syrups consisting of vitamins, mineral supplements, or medicine)
and studies  have shown that infants  do not need water when exclusively
breastfed ( WHO, 1991). In any case only 31% of children experience the
benefits of breastfeeding (UNICEF, 2000).

So... we have some real problems in poor settings!!



Dr.Harry Osore
Vice President, International Medical Affairs
Arc-Ocean Medical  LLC
5454 Wisconsin Ave, Suite 500
Chevy Chase, MD 20815
USA
Tel: 1 301 654 4800
Fax: 1 301 656 0501
Email: harryosore@arc-ocean.com 
           medical@arc-ocean.com 
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Dr Lilian Wambua wrote:

If you advocate exclusive breastfeeding for confirmed HIV positive mothers
for Africa, why do you not do the same for women in the developed world, if
the risks of MTCT is that negligible? Are you aware that most of those women are already nutritionally compromised because of AIDS and that breastfeeding is just another added strain in her nutritional requirements? Do you have any studies to confirm that children who are born to mothers LWHA and are breastfed thrive better than those that are not breastfed. Are you not promoting double standards in a lethal condition?



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