1. Breastmilk Substitutes and the Code
Working Group 2
Breastmilk Substitutes and the Code

2. 3 positions all HIV positive women should receive formula
all HIV positive women should breastfeed
all HIV positive women should be provided with full information to make an informed choice

3. Disagreements
Code allows/doesn’t allow free formula distribution where govt procures it (but acknowledged Code is best tool we have)

4. Discussion focussed on:
Conditions (national, implementation and individual levels)
How to prevent spillover of replacement feeding and messages
research recommendations

5. Areas of agreement/outcome
provision of free formula skews the ‘informed” choice
existing research needs to be critically reviewed and all research should be independent of commercial interests (pharmaceutical and infant feeding companies)
nutritional and financial support needed for all HIV+ positive mothers

6. Outcomes (continued)
monitoring of health outcomes for mother & child needed (all infant feeding options)
strengthening of training (lact management, counseling & Code), BFHI, Code impl at nat. level, maternity protection (workplace & legislation)
situation analysis needed into five conditions (AFASS) before considering formula provision