By Chioma Obinna
In as much as Mother-to-Child -Transmission (MTCT)of HIV is almost entirely preventable where services are available, infant feeding choices for the HIV-infected women remains one of the most contentious issues in efforts to preventÂ MTCT of HIV in resource poor countries like Nigeria.
Statistics have shown over 7400 new HIV infections daily, about 1000 are in children less than 15 years of age while 90 percent are acquried during pregnancy, child birth and the post natal period through breast feeding.
However, a high percentage of MTCT of HIV can be attributable to breast feeding and yet breast feeding is known to confer several protective health benefits to the infant and it is the cultural norm in many communities in Nigeria.
These facts alone, according to the Chairman of the West African College of Nursing (WACN), Nigeria Chapter, Prof Mildred John pose a dilemma both to health care provider and to the infected pregnant mother.
In recognition of these and others, the Nigerian chapter of WACN organised a 2- day sub â€“ regional workshop on the Prevention of MTCT of HIV/AIDS for nurses in Lagos.
Giving insight into the problem of infant feeding choices, John lamented that HIV infection is wreaking havoc and taking a toll on the population.
Without intervention 15- 45 per cent of infants born to mothers living with HIVÂ will become infected,while 5-10 per cent would occur during pregnancy, 20 per cent during labour and delivery and 20 per cent through breast feeding.
John noted that PMTCT can be acvhieved through giving the HIV positive pregnant women a combination of antiretrovirtal (ARV) drugs from late in pregnancy until six months inmto breast feeding as well as ensuring safer infant feeding practices.
In her key note address entitled; â€œMother â€“ To â€“ Child â€“ Transmission: Implication on infant Feeding and Nutrition in Children:, Dr. Dayo Lajide from the Lagos State AIDS Control Agency, (LSACA) recommended that infant feeding should depend on a motherâ€™s individual situation as replacement feeding can be much nmore hazardous in resources constrained countries like Nigeria.
She advocated for support for mothers who choose replacement feeding as it could be challenging even in the best of circumstances.
In her words, â€œReplacement feeding is the only 100 per cent effective way to prevent Mother â€“ To- Child Trasnmsission of HIV after birth. This benefit however, must beÂ weighed against practical difficulties and the risk from other illnessesâ€
Lajide stressed that as part of efforts to support mothers who choose replacement feeding, counsellors must emphasise the need for sterile equipment and correct dilution and the dangers of keeping prepared formula for long periods in a room temperature.
â€œMothers should also be taught how to prevent breast engorgement, particularlyÂ without drugs and how to to recognise and treat dehydration when it occursâ€.