[pronut-hiv] Wet nursing a much safer option than breastmilk substitute feeding

["Marie McGrath, ENN" <marie@ennonline.net>]

Dear Katherine
Have you contacted UNICEF in Malawi? Wet nursing is a much safer option 
than breastmilk substitute feeding and I think it would be well worth 
exploring local practices and cultural issues around wet nursing and 
pursuing this further. Death from diarrhoea through poor artificial 
feeding is going to pose a bigger more immediate risk than HIV 
transmission is. A recent analysis (reference below) showed that in 
countries where IMR > 25/1000 live births, /exclusive breastfeeding for 
six months ^ /produces the best outcome when compared to replacemnet 
feeding from birth or no postnatal intervention. This study is not 
intended for use for individual decisions for infant feeding but 
indicates the risks of replacement feeding in low-income countries.
Regards
Marie McGrath
ENN


Piwoz EG and Ross JS (2005): Use of Population-Specific Infant Mortality 
Rates to Inform Policy Decisions Regarding HIV and Infant Feeding^. The 
American Society for Nutritional Sciences J. Nutr. 135:1113-1119, May 2005



Katherine Schwarz wrote:

>Thank you so much for the information.  I'm a nutritionist from the US working here in Malawi and we certainly never studied what one does in situations like this.
>  I'm working in a hospital here and we have a few babies whose mothers have either died or are too sick to produce breast milk.  So for some, they may have a chance to breast feed later on if the mother gets better, but some will not.  The orphanages here have a bigger problem than I do in the hospital.  We have a maternity ward and I've thought about asking new mothers to be wet nurses, but so many are HIV+ and even more don't know their status, that that's problemmatic.
>  I have no idea why infant formula isn't available anymore in Malawi.  I'm in touch with the Ministry of Health, but they haven't provided an explanation either, nor a solution.
>  But we will do the best we can.
>  Thanks again for your reply,
>  Katherine Schwarz
>
>Marie McGrath <marie@ennonline.net> wrote:
>  
>Dear Kathy
>You can access resources on infant feeding that include artificial 
>feeding on the Emergency Nutrition Network (ENN) website 
>(http://www.ennonline.net) - Module 2 training material includes a 
>section that deals with the management of artificially fed infants and 
>annexes recipies with guidelines on cup feeding young infants, etc. If 
>you send me your mailing address, I am happy to send youa print copy of 
>the resources. Although they have been developed for emergency settings, 
>they are applicable in non-emergency settings.
>As previous respondents have said, wet nursing would be a preferable and 
>much safer option for infants under six months. Is this just an isolated 
>case you are talking about?
>If there is no source of breastmilk, then locally purchased infant 
>formula would have a nutritional advantage over a modular feed which is 
>distinctly lacking in micronutrients and there are no formulations 
>around whereby you could practically add micronutrients to a modular 
>feed. It also depends whether you are talking about temporary use of a 
>breastmilk subsitute until a mother recovers, so a few days of a 'home 
>recipe' feed will have less significance than if a young infant is going 
>to be dependant on it.
>Finally, I am very interested to know why has imported infant formula 
>become scarce in Malawi?
>Regards
>Marie McGrath
>Emergency Nutrition Network
>
>Waindim Dorcas wrote:
>
>  
>
>>You can prepare corn pap mixed with soyar bean powder or ground groundnuts, this will be very nutritive for the baby.
>>Dorcas, AWARE HIV/AIDS
>>CBCHB, Cameroon
>>
>>Waindim Dorcas
>>
>>---- Katherine Schwarz wrote:
>>April 8, 2006
>>
>>Does anyone out there know of any substitute for infant formula for infants (under 6 months) whose mothers are too sick to breastfeed or whose mothers have died. As you may know, imported infant formula had become very scarce in Malawi and is now just about impossible to find.
>>Any suggestions you might have would be appreciated.
>>
>>Kathy Schwarz
>>Zomba Central Hospital
>>
>>
>>    
>>
>>