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Challenges in infant and young child nutrition in the context of HIV

Tin Tin Sint1, Ronnie Lovich, Wendy Hammond

  • 1aNutrition Section, Program Division, UNICEF, New York, New York bElizabeth Glaser Pediatric AIDS Foundation (EGPAF) cFANTA/ FHI 360 dBaylor International Pediatrics AIDS Initiative (BIPAI) eStrategic Information, Catholic Medical Mission Board (CMMB) fDivision of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia gDepartment of Maternal, Newborn, Child and Adolescent Health, WHO, Geneva hOffice of HIV/AIDS, USAID iGlobal AIDS Program, Health Resources and Services Administration (HRSA), Rockville, MD.

AIDS (London, England)
|December 24, 2013
PubMed

Insights

Exclusive breastfeeding for HIV-positive mothers on antiretroviral drugs (ARVs) is recommended, but implementation faces challenges. More research is needed to address malnutrition and knowledge gaps in pediatric HIV care.

Area of Science:

  • Pediatric HIV/AIDS
  • Maternal and Child Health
  • Infectious Diseases

Background:

  • Consensus exists on optimal infant and young child feeding (IYCF) practices for all infants.
  • Guidelines for HIV-positive mothers have evolved significantly since 2000.
  • Antiretroviral drugs (ARVs) have reduced mother-to-child HIV transmission risks.

Purpose of the Study:

  • To explore issues and evidence related to IYCF for pediatric HIV prevention and care in resource-limited settings.
  • To address challenges in implementing current HIV treatment and infant feeding guidelines.
  • To identify knowledge gaps in managing HIV-exposed and HIV-infected children.

Main Methods:

  • Review of current evidence and guidelines on infant and young child feeding (IYCF) for HIV-positive mothers.
  • Analysis of implementation challenges in resource-limited settings.
  • Identification of knowledge gaps in pediatric HIV nutrition and care.

Main Results:

  • WHO recommends either avoidance of breastfeeding or exclusive breastfeeding for 6 months with ARVs for HIV-positive mothers.
  • Implementation is hindered by inadequate healthcare provider training and weak support systems.
  • Significant knowledge gaps exist regarding malnutrition, ARV exposure effects, and nutrition interventions for HIV-infected children.

Conclusions:

  • Progress in reducing pediatric HIV infection is noted, but sustained commitment is crucial.
  • Addressing implementation challenges and knowledge gaps is vital for eliminating postnatal HIV transmission.
  • Meeting the nutritional needs of HIV-exposed and HIV-infected children requires ongoing political, financial, and scientific support.

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