Use of population-specific infant mortality rates to inform policy decisions regarding HIV and infant feeding.

Mother-to-child transmission of HIV occurs during pregnancy, at the time of delivery, and through breastfeeding (BF). WHO recommends avoidance of all BF when replacement feeding (RF) is affordable, feasible, acceptable, sustainable, and safe. Otherwise, exclusive breastfeeding (EBF) followed by early BF cessation is recommended.

Modeling the effects of different infant feeding strategies on infant survival and mother-to-child transmission of HIV.

Objectives: We investigated how, under various conditions, the risk of mother-to-child transmission of HIV through breastfeeding compares with the risk of death from artificial feeding.

Methods: We developed a spreadsheet simulation model to predict HIV-free survival during 7 age intervals from 0 to 24 months for 5 different infant feeding scenarios in resource-poor settings.

Results: Compared with artificial feeding, breastfeeding during the first 6 months by HIV-positive mothers increases HIV-free survival by 32 per 1000 live births.

Contribution of breastfeeding to vitamin A nutrition of infants: a simulation model.

Objective: To provide information on the potential contribution to vitamin A nutrition in infants of strategies for improving maternal vitamin A status and increasing the consumption of breast milk.

Methods: The contribution of breastfeeding to the vitamin A nutrition of children in eight age groups between 0 and 24 months was simulated under four sets of conditions involving two levels of breast milk consumption with or without maternal vitamin A supplementation.

Findings: During the first 6 months, optimal breastfeeding on its own (compared with withholding colostrum and then partially breastfeeding after the first week) was as effective as postpartum maternal supplementation alone, retinol intakes being increased by 59 micrograms per day and 68 micrograms per day, respectively.

Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso.

Objectives: To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa.

Design: Multisite cross sectional survey.

Participants: Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged < or =5 months in 16 cities.