title: Promoting safe infant feeding practices - the importance of structural, social and contextual factors in Southern Africa.
abstract: There has been significant progress towards the goal of eliminating vertical transmission of HIV by 2015. However, a question that remains is how we can most effectively prevent late postnatal transmission of HIV through infant feeding. Guidelines published by the World Health Organization in 2010 have been widely adopted. These guidelines place strong emphasis on exclusive breastfeeding, in some countries over-turning a prior emphasis on formula feeding. Where available, provision of antiretroviral treatment for HIV-positive mothers or prophylaxis for infants offers additional protection against vertical transmission through infant feeding. However, merely changing guidelines is not sufficient to change practice, particularly with regard to culturally sanctioned forms of feeding, such as mixed feeding. This commentary highlights structural, social and contextual barriers to effective implementation of the guidelines and suggests ways to address some of these barriers.
authors: Perinatal HIV Research Unit, University of the Witwatersrand/Chris Hani Baragwanath Hospital, Soweto, South Africa. ianray@telkomsa.net
authors: Ray
authors: R
authors: Lazarus
authors: Helen
authors: H
authors: Struthers
authors: Avy
authors: A
authors: Violari
mesh_terms: D000353:Africa, Southern; D019380:Anti-HIV Agents / Q000008:administration & dosage; D001903:Bottle Feeding; D001942:Breast Feeding; D018890:Chemoprevention / Q000379:methods; D005247:Feeding Behavior; D005260:Female; D017408:Guidelines as Topic; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D012931:Social Environment
chemical_list: D019380:Anti-HIV Agents
keywords: community engagement; counselling; exclusive breastfeeding; formula feeding; guidelines; infant feeding; mixed feeding; prevention; vertical transmission of HIV
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