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[Geneva, Switzerland], World Health Organization [WHO], 2006. 9 p.The purpose of this paper is to examine the nutritional aspects of feeding home-modified milk. This paper focuses only on non-breastfed children aged 0 to 6 months with no access to infant formula. Feeding older non-breastfed infants is described in another WHO document. Other problems, including the risk of dilution error when modifying the milk, the risk of bacterial contamination, and the risk that it will cause occult bleeding in the gut if not adequately boiled are acknowledged, but will not be discussed here. (excerpt)
Geneva, Switzerland, WHO, 2006. 11 p.The Code is a set of recommendations to regulate the marketing of breast-milk substitutes, feeding bottles and teats. The Code was formulated in response to the realization that poor infant feeding practices were negatively affecting the growth, health and development of children, and were a major cause of mortality in infants and young children. Poor infant feeding practices therefore were a serious obstacle to social and economic development. The 34th session of the World Health Assembly (WHA) adopted the International Code of Marketing of Breast-milk Substitutes in 1981 as a minimum requirement to protect and promote appropriate infant and young child feeding. The Code aims to contribute "to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution". The Code advocates that babies be breastfed. If babies are not breastfed, for whatever reason, the Code also advocates that they be fed safely on the best available nutritional alternative. Breast-milk substitutes should be available when needed, but not be promoted. The Code was adopted through a WHA resolution and represents an expression of the collective will of governments to ensure the protection and promotion of optimal feeding for infants and young children. (excerpt)
BMJ. British Medical Journal. 2007 Mar 10; 334(7592):487-488.Recently, the World Health Organization updated its recommendations of 2000 on infant feeding in the context of HIV. At that time, data had just been published quantifying the risk of infection through breast feeding so avoiding breast feeding was acknowledged as the only effective way of avoiding transmission. WHO had also just published a meta-analysis of the mortality risks of not breast feeding, but in non-HIV infected populations. Considerations of these data resulted in the statement that, "When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended." Since the 2000 recommendations, the main emphasis of most national programmes aimed at preventing mother to child transmission of HIV has been to avert transmission of HIV in young infants. The most difficult challenge has been how to make breast feeding safer in communities with a high prevalence of HIV where breast feeding is the traditional mode of feeding. Remarkably, the dilemma of infant feeding and HIV has split scientific communities and programme managers into opposing camps. Even with the risk of HIV transmission, some maintain that breast feeding may still be the best option for many mothers infected with HIV because of its anti-infective and nutritional advantages. Others promote commercial infant formula, arguing that the risks of diarrhoea and malnutrition associated with formula feeding are lower in most urban communities, or that the risks of not breast feeding may not be as great for infants born to mothers infected with HIV who, to prevent transmission, choose to give formula milk from birth; it has been suggested that this active decision making and motivation may result in safer preparation and use of formula milk. (excerpt)
Protecting breast feeding from breast milk substitutes. Royal college supports promotion of breast feeding [letter]
BMJ. British Medical Journal. 1998 Oct 3; 317(7163):949-50.The Royal College of Paediatrics and Child Health suggested interventions to increase the number of women who breast feed their babies in its report to the Acheson inquiry on poverty and health. The UN Children's Fund (UNICEF) had a stand, which offered information on its 1991 initiative promoting breast feeding, at the trade exhibition of the college's annual general meeting in 1998. Members and fellows gave unequivocal support to a policy statement which encouraged exclusive breast feeding for the first 4-6 months of an infant's life followed by breast feeding accompanied by weaning food for as long as the mother wished. However, Costello and Sachdev, in discussing attempts by manufacturers of infant formula to seek "endorsement by association" or "passivity towards their products," chastised the Royal College for not joining an interagency group on breast feeding and for accepting research funds from infant formula manufacturers. The College did not join the interagency group because of concerns regarding the proposed research methodology. The College will accept no more research funds or donations from infant formula manufacturers until the recommendations and report of its ethics committee regarding breast milk substitute marketing, which were requested by the 1997 annual general meeting, are finished in late 1998.
[Consensus declaration on the World Health Organization [WHO] / UNICEF consultation on HIV transmission and breast feeding] Declaration de consensus a l'issue de la consultation OMS / UNICEF sur la transmission du VIH et l'allaitement au sein.
IMBONEZAMURYANGO / FAMILLE SANTE DEVELOPPEMENT. 1992 Dec; (25):18-9.In 1992, WHO and UNICEF held a Conference on HIV Transmission and Breast Feeding to review available information on the risk of HIV transmission via breast milk and to formulate recommendations on breast feeding. In all populations, regardless of the HIV infection rate, one must continue to defend, promote, and protect breast feeding. Where infection and malnutrition are the main causes of death among newborns, the risk of death linked to these infections is especially high among newborns who are not breast fed. Under conditions where the infant is less likely to contract HIV infection by breast milk than die of other causes, it is best to breast feed. If women under these conditions have access to other infant feeding methods, it is necessary to offer them the option of an HIV test while respecting confidentiality. When infectious diseases are not the main causes of death, HIV infected pregnant woman should be advised to use breast milk substitutes. Pregnant women of unknown HIV status should be advised to undergo an HIV test before delivery. Pressure from manufacturers should not influence HIV infected mothers in their choice of artificial feeding, as stated in the International Code on the Commercialization of Breast Milk Substitutes. HIV-related counseling should aim to help HIV infected adults address infant feeding methods, the risk of HIV transmission to children if the woman becomes pregnant, and the risk of HIV transmission at the time of sexual relations and via blood. All HIV positive adults who wish to avoid pregnancy should use family planning services and information. In all countries, the first priority to prevent vertical HIV transmission is prevention of HIV infection in women of reproductive age. Women must be taught how to protect themselves from HIV infection. Society must grant them the means to easily procure condoms and assure prevention and treatment of sexually transmitted diseases.