Today, at a meeting to share information on the new policy guidelines – the Infant and Young Child Feeding policy, mothers were encouraged to exclusively breastfeed for the first six months of their baby’s life.
The meeting was called by the KZN Department of Health as it prepares to rollout the new policy guidelines as from 1 January 2011. The policy was first announced by the World Health Organisation (WHO) in 2010. The guidelines were developed following significant programmatic experience and research evidence regarding HIV and infant feeding accumulated since 2006.
“Prevention of mother to child transmission comes at a cost of excess deaths in uninfected infants therefore need to consider overall outcomes, i.e. we needed to consider how many HIV infections we prevented as well as how many infants survive,” said Professor Anna Coutsoudis of the University of KwaZulu-Natal’s Department of Paediatrics and Child Health.
She said that breastfeeding transmission of HIV is over-estimated by many including healthcare workers. However, the latest data suggests that exclusive breastfeeding in the first six months of life gives transmission of about two to four percent.
Giving antiretroviral prophylaxis to mothers or infants significantly reduces this further; she said. There is no evidence of significant drug related adverse events (side effects) following the use of antiretroviral (ARV) prophylaxis.
In a study conducted in Ghana, Peru and India; where 9 424 cases of Infant feeding patterns were studied, it was shown that non breastfeeding infants had a ten (10) fold higher risk of dying when compared to predominantly breastfed infants.
“If we were to look at the most important interventions to prevent child deaths, breastfeeding is recognised as the single most important intervention. It can reduce under five deaths by 13%,” said Ms Lenore Spies of the KwaZulu-Natal Department of Health. “While the risks of not breastfeeding by HIV uninfected mothers are well documented, there is now hope that HIV infected mothers – with the necessary support and motivation from their partners and families – would somehow be different.”
In KwaZulu-Natal 2 237 cases of children in 2008/09 were admitted in public health hospitals with severe malnutrition which is an unacceptably high number and is related to inappropriate feeding and disease. Pneumonia and diarrhoea are two leading causes of morbidity and mortality in children under five years. In 2009/10 period the number of children under five years reporting to Public Health Facilities with diarrhoea increased from 46 511 (2008/09) to 50 471 (±8.5%) and of these 9 092 (18%) children had to be admitted to hospital.
The overall aim of the new guidelines is to improve HIV free survival of infants born to mothers known to be HIV infected. Based on the evidence considered, the new policy guidelines are changing perceptions around breastfeeding and that infants should received ARVs for one year or the mother should receive ARVs.
“We have started a public mobilisation and information programme where we talk to community healthcare workers, traditional leaders, traditional birth attendants and churches to ensure that mothers are supported and protected during breastfeeding,” added Ms Spies.
“67% of women who are not on the prevention of Mother to Child Transmission programme continue to formula feed. Their infants have the highest risk of HIV transmission or death. Experience seems to point to the fact that mothers are making inappropriate choices often because of confusion. Each of us has the power to give life meaning to make our time and our words into instruments of love and hope. Let’s support, protect and promote exclusive breastfeeding for the first six months of every baby’s life.” concluded the MEC for Health Dr Sibongiseni Dhlomo.
The department will roll out a key infant feeding and related nutrition messages through multiple communication channels, including interpersonal communication, community mobilisation events, and local mass media. Major activities will include mobilising and training existing frontline health staff, non-governmental organisations (NGO) personnel, and community members on infant feeding and related nutrition issues.
Enquiries:
Chris Maxon
Cell: 083 447 2869
