Breastfeeding accounts for 30–40% of mother to child transmission in populations where breastfeeding is practised until the child is two years of age. However, replacement feeding, if not carried out properly, is associated with increased risk of morbidity and mortality at a young age. This is particularly the case in low-resource settings.
Exclusive breastfeeding during the first six months of life is associated with lower transmission of HIV and improved child survival compared to non-exclusive breastfeeding children in developing countries.
There are a number of common terms used to describe infant feeding practices. You may already be familiar with these terms. The Box below summarises what each one means.
Mothers who are able to give exclusive replacement feeding can usually do this successfully if a number of factors are in place. These are known as the AFASS factors, and we have summarised these in the box below.
Acceptable: The mother has no barrier in choosing a feeding option for cultural or social reasons, or for fear of stigma and discrimination
Feasible: The mother (or family) has adequate time, knowledge, skills, and other resources to prepare feeds and to feed her infant, and the support to cope with any family, community and social pressure
Affordable: The mother and family, with available community and/or health system support, can pay for the costs of the feeding option, including all ingredients, fuel and clean water, without compromising the family's health and nutrition spending.
Sustainable: The mother has access to the continuous and uninterrupted supply of all ingredients and commodities needed to implement the feeding option safely for as long as the infant needs it.
Safe: Replacement foods are correctly and hygienically prepared and stored in nutritionally adequate quantities; infants are fed with clean hands using clean cups.
Why do you think that exclusive replacement feeding might be difficult for some mothers in your community?