The 2010 South African Prevention of Mother-To-Child HIV Transmission (PMTCT) Guidelines
incorporated this evidence and were broadly supportive of HIV-infected women breastfeeding
their infants, but stopped short of adopting breastfeeding as the programme’s default feeding
choice. The Tshwane Declaration in August 2011 shifted South Africa squarely onto the
breastfeeding restoration path. Besides promoting, protecting and supporting breastfeeding
generally, the declaration specifically adopts breastfeeding as the default feeding method for
HIV-exposed infants and promotes human milk banks to support breastfeeding and breast milk
feeding. The Tshwane Declaration was followed by the promulgation of regulations (R991/2012)
to enforce the international code on marketing of breast milk substitutes. Nevertheless, South
Africa still lags behind many other African countries in the uptake and duration of breastfeeding
and the duration of exclusive breastfeeding