There is evidence that the additional risk of HIV transmission through breastfeeding is about 5-20%. HIV can be transmitted through breast milk at any point during lactation. Infants born to HIV-positive mothers who have escaped perinatal infection have a lower risk of acquiring HIV if they are not breastfed. However, their risk of death is increased if they are not breastfed in situations where there is no regular access to nutritionally adequate, safely prepared breast milk substitutes (AFASS feeds)
| < 6 months | Exclusive breastfeeding |
| > 6 months | Add complementary food, breast-feeding should continue until 18 months or longer if mother on ART |
| Presentation | Differentials | Investigations | Treatment |
|---|---|---|---|
| Weight loss or absence of weight gain | Food insecurity Co-infections (e.g. TB, chronic diarrhoea) ART failure |
Consider TB investigations Consider CD4 +/- viral load if on treatment for >6 months |
RUTF (Chiponde *) if W/H < 85% |
| Weight | Sachets per day | 4 weeks supply |
|---|---|---|
| 5-10 kg | 1 | 15 sachets |
| 10-20 kg | 2 | 30 sachets |
| >20 | 3 | 45 sachets |