Exclusively Breastfeed and Take ARVs

• Infant feeding recommendations are given to the mother at health facility
• Exclusive breastfeeding (giving ONLY breast milk) for the first 6 months together with special medicines (ARVs) for either mother or baby greatly reduces the chance of HIV passing from an HIV-infected mother to her baby.
• When an HIV-infected mother exclusively breastfeeds, her baby receives all the benefits of breastfeeding including protection from diarrhoea and other illnesses.
• Use counselling cards on exclusive breastfeeding and building your milk supply (Counselling Cards 3 to 7).
• Support the mother to feed her baby:
• Follow recommended breastfeeding practices.
• Very important to avoid mixed feeding.
• Identify breast conditions of the HIV-infected mother and refer for treatment.
• HIV-exposed babies should be tested when they are about 6 weeks old.
• All babies who test positive at 6 weeks should breastfeed exclusively until 6 months, even in the absence of ARV interventions, and then continue to breastfeed for up to two years or longer. Complementary foods should be introduced at 6 months, as recommended.
• All breastfeeding babies who test negative at 6 weeks should continue to exclusively breastfeed until 6 months, even in the absence of ARV interventions, and continue to breastfeed until 12 months. Complementary foods should be introduced at 6 months, as recommended. After 12 months, breastfeeding should only stop once a nutritionally adequate and safe diet without breast milk can be provided.

Notes for community worker:

• When mother is on life-long treatment and breastfeeds, her baby should receive daily NVP from birth to 6 weeks.
• With one type of ARVs (depends on national policy) mother takes these medicines up to 1 week after breastfeeding stops and her baby receives daily NVP from birth to 6 weeks.

Notes for community worker continued:

• With another type of ARVs (depends on national policy) mother takes these medicines for 1 week after birth and her baby receives daily NVP from birth until 1 week after breastfeeding stops.
• Explain the benefits of ARVs, both for the mother’s health if she needs them and for preventing transmission of HIV to her baby.
• Support HIV-infected women to go to a clinic that provides ARVs, or refer for ARVs.
• Reinforce the ARV message at all contact points with HIV-infected women and at infant feeding support contact points.
• Refer to health facility if HIV-infected mother changes feeding option or her ARVs are going to run out soon.

Reminder: This Counselling Card is for countries where national policy for HIV exposed infants is exclusive breastfeeding + ARVs.