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The findings have been important for informing international and national guidelines on MTCT prevention in developing countries where, due to poverty, lack of reliable and affordable supply of replacement feed and stigma associated with HIV/AIDS, HIV-infected women have little or no option other than to breastfeed their infants.
Women with severe psychological and somatic illness, those having given birth more than 1 week ago, and those planning to replacement feed were not included in the study.
In fact, choosing to use replacement feed is equivalent to announcing their HIV status, and the consequences of this are far reaching and could involve violence and divorce [ 22].
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Then, over a period of a few days to a few weeks, they may gradually stop breast-feeding (exclusive breast-feeding with early cessation), provided the conditions for replacement feeding or other breast-milk options are in place.
In Britain, where sterile water and bottles are available, "safe replacement feeding" is recommended.
For infected mothers who have to breast feed because they live where water is contaminated, the health organization now recommends weaning as soon as a safe and acceptable replacement feeding is available.
Problem: Vertical transmission of HIV via breast milk remains one of the biggest challenges in the global AIDS epidemic, particularly in developing countries where replacement feeding is often not feasible.
Exclusive breastfeeding (EBF) for six months is the mainstay of global child health and the preferred feeding option for HIV-infected mothers for whom replacement feeding is inappropriate.
Maternal infant feeding choice was supported, and replacement feeding from birth, or from breastfeeding cessation until 9 months of age, was provided free of charge.
A three-month supply of infant formula and a fortified weaning cereal was provided and training and education to make replacement feeding as safe as possible was done.
EBF is unlike replacement feeding where reduction of HIV transmission has to be carefully balanced against increased mortality due to other infections.
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