Abstract Breastfeeding has been shown to benefit both
maternal and child immune status. The impact of exclusive
breastfeeding in the presence of HIV infection on maternal
and child health is still unclear. Socio-economic factors
make breast-feeding an important source of nutrition for an
infant 6 months and under in the developing world. A
prospective study was conducted to examine the impact of
feeding mode on various maternal indices including
anthropometry; body composition indicators (using FTIR);
haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease
progression. In infants we examined the impact on growth,
development and morbidity. AFASS criteria (affordable,
feasible, accessible, sustainable and safe) were fulfilled by
38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding
groups in terms of haematological, immunological and
body composition changes were seen. Breastfeeding
mothers had significantly lower events with high
depression scores (P = 0.043). Breastfeeding infants had a
significantly lower risk of diarrhoea and hospitalisation at
3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development
scores and growth parameters. Breastfeeding is not harmful
to the mother in the presence of HIV infection. Mothers are
still choosing formula feeding inappropriately despite
counselling about the AFASS criteria. Breastfeeding is
beneficial to the infants especially in the first 3 months of
life.