UNICEF's Position On Breast-Feeding For HIV-Positive Women Clarified

Although UNICEF"support[s] programs to prevent the transmission of HIV from mother to child in more than 90 countries," the agency "does not now provide infant formula to mothers with HIV and has never provided infantf ormula in Botswana," Alan Court, a UNICEF program director, writes ina Washington Post letter to the editor in response to a July 23 Post article that examined the effects of a formula program in Botswana to prevent MTC HIV transmission (Court, Washington Post, 8/6).

The Post reported that Botswana in 1997 joined a UNICEF-led effort to encourage HIV-positive women to use formula whenever supplies could be provided safely and reliably. The country agreed to pay for the formula program as a service for new mothers.

However, government clinics "often ran out of cans of formula, forcing parents and grandparents to buy cow's milk and feed their children with diluted porridge or even flour and water," the article said. UNICEF, after providing training and technical assistance to the formula program in Botswana, began phasing out its infant-feeding programs in 2002, according to the Post (Kaiser Daily HIV/AIDS Report, 7/24).

According to Court, UNICEF in 1999 began providing infant formula in eight countries -- not including Botswana -- for pilot projects to prevent MTC HIV transmission. He adds that the agency stopped providing formula in 2002 when it was found that some women who fed formula to their infants also were breast-feeding -- "multiplying the threat of diarrhea and respiratory infections, as well as HIV transmission."

Court writes that although UNICEF does not provide infant formula to HIV-positive mothers, the agency "sustain[s] efforts to ensure that women know their HIV status, are given the advice they need to make informed decisions about infant feeding and the backup to implement their personal decisions"