21.2
Infant and child feeding
Clinical HIV Guidelines, 5th Edition, 2022. Chapter 21, Newborn care and postnatal follow up.
Clinical description
- Feeding recommendations are the same for all infants, regardless of HIV exposure or HIV
infection status.
- Give only breast milk up to age 6 months.
- Gradually start complementing breastfeeding with suitable hygienically prepared foods from
age 6 months (such as Likuni Phala, fruits, vegetables, beans, ground nuts and soya).
- Aim to stop breastfeeding around age 22 months, so that the final HIV test can be done at age
24 months (6 weeks after breastfeeding has stopped).
- Stop breastfeeding gradually over a period of 1 month (no rapid cessation).
- Replacement feeding (formula) is NOT recommended unless women are unable to breast feed.
- Monitor weight, height and MUAC according to schedule using standard MOH charts and intervene
if no adequate weight-gain.
- Give only medicines prescribed by a health professional.
- Start breastfeeding immediately after birth. Explain and observe optimal breastfeeding:
o Empty both breasts properly to avoid breast engorgement.
o Ensure proper attachment and positioning to minimize nipple cracks and fissures.
o Watch out for signs of breast infection (pain, swelling, heat, redness)
- Don’t feed baby from infected breast. Express infected breast to avoid engorgement.
Discard expressed milk – do not feed to baby.
- Go to health facility for treatment. Refer to latest Malawi Standard Treatment
Guidelines 108 Newborn care and postnatal follow up
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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