- Have a written breast-feeding policy that is routinely
communicated to all health care staff
- Train all health care staff in skills necessary to implement
- Inform all pregnant women about the benefits and management of
- Help mothers initiate breast-feeding within a half-hour of birth
- Show mothers how to breast-feed, and how to maintain lactation
even it they should be separated from their infants
- Give newborn infants no food or drink other than breast-milk,
unless medically indicated
- Practice rooming-in, allow mothers and infants to remain
together - 24 hours a day
- Encourage breast-feeding on demand
- Give no artificial teats or pacifiers (dummies / soothers) to
- Foster the establishment of breast-feeding support groups and
refer mothers to them on discharge from the hospital or clinic
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- Breastmilk alone is the best possible food
and drink for a baby. WHO/UNICEF recommends that all infants be fed
exclusively on breastmilk from birth to six months of age, and
breastmilk together with complementary food for two years and
- Virtually every mother can breastfeed her
baby. It is helpful to have support and assistance from family,
friends, health workers and employers.
- Babies should start to breastfeed as soon as
possible after birth. Baby should be breastfed whenever he or she
- Frequent suckling at breast is normal,
satisfies and comforts the baby, and causes more milk to be made.
The time between feedings gradually lengthens as the baby gets
- Breastfeeding helps babies grow normally and
protects them from getting sick. Other baby foods do not give
protection, and can cause illness if not made up and fed properly.
- When a child reaches six months old, a
variety of other foods can be introduced, but breastfeeding should
continue well into the second year of a child's life and for longer
- Mothers working/employed outside the home can
continue breastfeeding by expressing milk or breastfeeding during
the workday. Adequate maternity leave, breastfeeding breaks,
facilities, and nearby childcare are helpful.
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HIV passes via breastfeeding to about
14 percent of infants born to HIV-infected women, at least if the
breastfeeding is not exclusive. Preliminary research suggests that HIV
may transmit through breastmilk at much lower levels, perhaps hardly at
all, during exclusive breastfeeding (that is, when babies receiving
nothing but breastmilk, not even water).
HIV in infants not given antiviral drugs nearly always results in death.
But babies are also highly likely to die from diseases resulting from
artificial feeding where supplies, sanitation and hygiene, and medical
care are not always available. This risk is not yet quantified in many
settings, including Africa. Thus it is not always possible for either
health workers or mothers to know which is the wisest choice.
In general, the UN agencies advise that complete replacement of
breastmilk with infant formula be undertaken only where "(1) the family
has reliable access to sufficient quantities for at least six months,
(2) the family has the resources - water, fuel, utensils, skills and
time - to prepare it accurately and hygienically. "Other options include
heat treatment of expressed breastmilk and wet nursing by a woman who
has tested HIV-negative.
Key points on HIV/AIDS
Families need to have access to voluntary and
confidential HIV counselling and testing (VCT)
The highest risk of HIV transmission to the
breastfed baby appears to be during the early weeks and months of
breastfeeding when it may be indistinguishable from transmission
occurring during pregnancy or during birth. Although the risk of
transmission of HIV through breastfeeding by an already-infected
mother continues as long as the baby is breastfed, it appears to be
reduced with increasing age, particularly the baby exclusively
breastfed for the first six months of life.
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Breastfeeding should continue to be protected,
supported and promoted generally, as most mothers are not infected
or do not know their HIV status. Indeed, in 2001 less than 1% of
women making antenatal visits in Africa for example even have access
The provisions of the International Code and the
BFHI should continue to be implemented even in areas with a high
prevalence of HIV/AIDS.
- The best way to protect babies form becoming infected is to
protect their mothers from being infected with HIV by their sexual