Two major African studies that were submitted at the July 2009 international AIDS conference in Cape Town were instrumental in guiding the new recommendations by the WHO.
11 The two types of research showed that giving mothers a combination of antiretroviral therapy during pregnancy, delivery and the breastfeeding period reduced the risk of infecting the infants by 42 %.
12 Also, the WHO recommendations are largely based on the evidence provided by the research programs conducted in the past years in most African countries.
The major challenges that have hampered the implementation of these recommendations is the non-affordability of other alternative feeds to replace breastfeeding and inadequate information on appropriate practices of feeding, especially for those mothers unaware of their HIV statuses.13 These are among the many challenges that have made the WHO, UNICEF and other organizations championing for better breastfeeding practices to come up to recommend practices for mothers so as to improve the survival chances of babies.
The main challenges that have been faced by these international and local organizations in the actualization of these recommendations are:
Poor living standards and livelihood.
As a result of the poor living standards in the underdeveloped nations, mothers have little or no time for breastfeeding their infants as they have to work for long hours so as to provide for their families.14With this, babies of HIV positive mothers have to be fed on other foods when their mothers are out to work and this hinders the exclusive breastfeeding recommended by the WHO.
Poor knowledge, myths, and misconceptions.
Many people in underdeveloped nations, especially in Africa, are tied by cultural values that undermine good breastfeeding practices for the HIV positive mothers.15Most cultures find it a taboo for mothers to keep off from breastfeeding,16 thus making even those that are HIV positive breastfeed their babies as well as give them other forms of food16, 17.
Poor social and professional support
Most families in the underdeveloped nations are not supportive when it comes to breastfeeding as most men take the issue of breastfeeding as one that is wholly womens and need not to take part in the whole process. They lack the knowledge that the breastfeeding process of a baby is dependent of both the father and the mother and fathers needs to take note and correct the mothers in case they dont practice desirable breastfeeding practices.16This leaves mothers with the full responsibility of deciding how the babies will be breastfed and whenever they make mistakes, it affects the health of the babies if being HIV positive16, 17.
Inadequate supply of antiretroviral drugs
Another major setback towards the campaign for better breastfeeding practices among the HIV infected mothers is the inadequate antiretroviral drug supply.17 In most underdeveloped nations, there has been a great challenge in the supply of antiretroviral drugs to hospitals where infected mothers can easily access them during pregnancy and in the period of breastfeeding.18 Therefore, infected mothers cannot easily access the drugs thus hindering the efforts that have been pot towards the realization of zero deaths as a result of HIV transmission through breastfeeding.
The WHO has been able to convince governments of many countries on the need to provide antiretroviral drugs at no cost to all mothers who are HIV positive throughout the pregnancy and during the breastfeeding period.17
They have also organized many sensitization programs such as the World breastfeeding week celebrated every year that has left women who are HIV positive educated on the benefits of better breastfeeding practices.18This has helped reverse the strong cultural beliefs and helped the women adhere to the breastfeeding rules if they were positive.
Provision of free formula feeds to women who are HIV positive has been achieved in many nations through fundings from the WHO and other organizations. The organizations have also been able to educate many governments on the need to provide free formula feeds to mothers as many are unable to afford the feeds.18This has made them readily available to all those that are HIV positive.
The WHO has been able to achieve the exclusive breastfeeding practice by educating women on the benefits of doing so and also by providing free supplementary feeds for the infants when they cease breastfeeding for those who are HIV positive.18, 19
The campaign by both the WHO and the UNICEF on better breastfeeding practices for those mothers who are HIV positive has many advantages. One of them is the achievement of a large number of HIV-positive women who adhere to the exclusive breastfeeding practice today.19 With this, there has been a reduction in the number of new HIV infections via breastfeeding from mothers to their children.20 Also, the campaign by the WHO has resulted in many nations providing supplementary feeds and antiretroviral medications for those mothers that are HIV positive both being pregnant and after birth. This has reduced the death rate for those mothers who are positive as prior to they had died and left their infants at a young age.21
In regard to these recommendations by the WHO, there is the need for every HIV positive mother to observe better breastfeeding practices. When better breastfeeding practices are observed, the WHO, the UNICEF and other humanitarian organizations will be at a better position so achieve zero cases of mother to child HIV transmission through breast milk. There is also the need for other local and international organizations to join hands so that there can be a total eradication of mother to child HIV transmission through breast milk. It is also the duty of every infected mother to practice these recommended practices as well as being under antiretroviral medication so as to save both their lives and those of their young ones.
Setegn,Tesfaye, Haile,Demewoz, & Biadgilign,Sibhatu.2015. Adherence to WHO breastfeeding guidelines among HIV positive mothers in Southern Ethiopia: implication for intervention. Dove Press.
Tsiku, P., & Eley, Brian. 2015. Outcome of universal life-long ART for all HIV infected pregnant and breastfeeding women and children less than 24 months regardless of WHO stage or CD4 count (PMTCT option B+) - a case study in a rural district, Malawi. University of Cape Town.
Kafulafula, Ursula K, Hutchinson, Mary K, Gennaro, Susan, Guttmacher, Sally, & Kumitawa, Andrew. 2013. Exclusive breastfeeding prenatal intentions among HIV-positive mothers in Blantyre, Malawi: a correlation study. (BioMed Central Ltd.) BioMed Central Ltd.
Liamputtong, P. 2011. Infant feeding practices: A cross-cultural perspective. New York: Springer.
In Aziato, L. 2014. Footprints of the nursing profession: Current trends and emerging issues in.
Abdul-Mumuni, S., Keeler, C., & James, K. 2014. Prevention of HIV Mother-To-Child-Transmission in sub-Saharan Africa.
Lumadi, T.G., & Shoopala, Naemi Ndahambemlela. 2012. Effective prevention of mother-to-child transmission of HIV at Oshakati District Health Centre in the Republic of Namibia. (http://hdl.handle.net/10500/6082.)
Ellen E. Hardy, Ellen Elizabeth Hardy Orientador, & Eliana Maria Hebling. 2005. Mulheres soropositivas para HIV: Sentimentos associados a maternidade e a orfandade. Biblioteca Digital da Unicamp.
Page-Goertz, S., McCamman, S., University of Kansas., & Best Beginnings Productions. 2001. Creating breastfeeding friendly environments. Sudbury, MA: Jones and Bartlett.
Jones, W. 2013. Breastfeeding and medication. London: Routledge/Taylor & Francis Group.
Leifer, G. 2011. Introduction to maternity & pediatric nursing. St. Louis, Mo: Elsevier/...
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