South Africa: Breastfeeding, not Formula, for Country's HIV-Positive Mothers

South Africa is phasing out a program that provides free formula to HIV-positive mothers. The move in all nine provinces is in support of the 2011 Tshwane Declaration that exclusive breastfeeding (EBF) be promoted starting The Tshwane Declaration calls for supporting EBF for all infants up to age six months, including those exposed to HIV; these babies should receive antiretrovirals (ARVs) to prevent mother-to-child transmission (MTCT), per World Health Organization (WHO) guidelines.

The declaration stems from concern over: South Africa's EBF rate, which, at 8 percent, is the world's lowest; high child mortality rates; and the fact that formula feeding increases the risk of death from diarrhea and pneumonia -- the largest killers of the nation's infants and children. Public health facilities will provide formula only by prescription.

Critics, however, say the declaration is too ambitious. "We can increase our EBF rate, but not to the extent that the Health Department believes is possible," said Haroon Saloojee, a pediatrics expert at the University of Witwaterstrand. Saloojee said greater concerns are the possibility of MTCT drug shortages in the public health sector, and ensuring that mothers adhere to infant ARV regimens.

"There's no way you can get those transmission rates unless you have a good and reliable service delivery and good and reliable adherence to those drugs," said Nigel Rollins of WHO.

Back to other news for April 2012