informed choice of infant feeding method by HIV positive women, as recommended by UNAIDS/WHO/UNICEF guidelines, may also be compromised by limited counsellor training. In-depth interviews with tanzanian HIV/AIDS counsellors indicate lack of knowledge or confusion about the actual risks and benefits of the different infant feeding options, counsellors falling back on directive counselling and lack of follow-up support to mothers as important berriers to good quality advice.
With formula-feeding,in the absence of peri-natal antiretroviral treatment,evidence from a randomised trial in kenya indicated 20.5% of HIV infectioniu the formula-fed infanta as conpared to 36.7% in the breastfed group. Though the women had access to a clean water supply and could make the formula safely,mortality at 24 mouths of age was very hight and did not differ between breastfed and non-breastfed infants. Formula-feeding in this population was shown to prevent babies from acquiring HIV but not from dying of other causes.
There is concern among breastfeeing advocates that in resource-poorcommunities, increased use of formula-feedibg by HIV positive mothers