【精品】体育新闻·绿茵总局成立足球工作组79

INFANT FEEDING AND HIV,Dr KANUPRIYA CHATURVEDIDr. S.K. CHATURVEDI,Lesson Objectives,Understand 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.,Introduction to Infant Feeding,ARV prophylaxis administered to the mother and infant reduces MTCT Up to 20% of infants breastfed by HIV-infected mothers are at risk of acquiring HIV National and UN infant- feeding recommendations and guidelines can reduce MTCT,Infant 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,Infant Feeding and Child Survival (contd.),Counselling and support of infant feedingImproves feeding practices Prevents malnutrition Prevents HIV transmission to infantsReduces the risk of death in children,Infant Feeding: HIV-Negative Mothers,UN RecommendationsExclusive breastfeeding for 6 monthsBreastfeeding continued for 2 years or beyond Introduction of nutritionally adequate and safe complementary foods after 6 monthsInformation to mothers about the risk of HIV-infection late in pregnancy or during breastfeeding,Exclusive Breastfeeding,Definition Giving an infant only breast milk, with the exception of drops or syrups consisting of vitamins, mineral supplements, or drugs No food or drink other than breast milk, not even water,Infant Feeding: HIV-Positive Mothers,WHO RecommendationsAvoid all breastfeeding if replacement feeding is : Acceptable Feasible Affordable Sustainable & SafeOtherwise, exclusive breastfeeding during the first months of life,Breast-milk Feeding Options: Exclusive Breastfeeding,Advantages Easily digestibleNutritious and completeAlways availableNo special preparation neededProtects from diarrhoea, pneumonia, and other infections/diseasesPromotes bonding,DisadvantagesRisk of passing HIV to babyRequires feeding on demandMother requires additional calories to support breastfeeding,Guidelines 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 mothers choice,Breast-milk Feeding Options:Exclusive Breastfeeding with Early Cessation,Advantage Terminates infants exposure to HIV,Disadvantages Breast-milk substitute is necessary Mothers breasts may become engorged Mother at risk of becoming pregnant if sexually active,Expressed 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,Replacement Feeding Options: Commercial Infant Formula,Advantages No risk of transmitting HIV Made especially for infants Includes most nutrients an infant needs Others can feed infant,Disadvantages 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 acup Not breastfeeding may raise questions about mothers HIV status,Replacement Feeding Options: Home-Prepared Modified Animal Milk,Advantages No risk of transmitting HIV Less expensive than commercial formula Can be used when commercial infant formula runs out Others can feed infant,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 mothers HIV status,Infant-Feeding Counselling and Support,Infant-feeding counselling, education, and support should Be provided before and after birth Be based on national protocol Be based on a womans circumstances Include information on infant-feeding options and advantages and disadvantages Provide women with safer feeding skills Include demonstrations or opportunities to practice Encourage partner or family involvement Provide disclosure support,Infant-Feeding Counselling and Support,Counselling VisitsAt least one during the antenatal period Immediately after birth Within 7 days of birth to monitor post-partum and infant-feeding progress Monthly follow-up sessions Additional sessions may be required during high-risk time periods,Infant-Feeding Counselling and Support,Infant-Feeding Counselling StepsSTEP 1: Explain risks of MTCTSTEP 2: Explain advantages and disadvantages of different feeding options, starting with mothers initial preferenceSTEP 3: Explore mothers home and family situationSTEP 4: Help mother choose an appropriate option,Infant-Feeding Counselling and Support,Infant-Feeding Counselling Steps (continued)STEP 5: Demonstrate how to practice chosen feeding option Replacement feedingExclusive breastfeedingOther breast milk options STEP 6: Provide follow-up counselling and support,Summary,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