AnotherLook is issuing a Call to Action to assure the best maternal/infant health outcomes in relation to infant feeding in the context of HIV/AIDS. This call is needed because current research, policy, and practice, often based on fear, are focused on the reduction of transmission while neglecting the impact on morbidity and mortality. This not only may be misleading but may inadvertently set back critical gains already achieved in public health as a result of the protection and promotion of breastfeeding.

We acknowledge the possibility that HIV may be transmitted through breastfeeding and that there is an urgent need for feeding guidelines. However, there is currently no published scientific evidence showing that infants born to mothers who are HIV positive would be healthier and/or less likely to die if they were not breastfed.

In light of the above, we call for immediate action to provide:

• Clear, peer reviewed research, with careful ongoing follow-up, which will provide sound scientific evidence of optimal infant feeding practices that lead to the lowest morbidity and mortality.
• Concise, consistent definitions of feeding methods, testing methods, HIV infection and AIDS.
• Development of research based infant feeding policies which are feasible to implement in light of prevailing social, cultural and economic environments; which address breastfeeding (particularly exclusive breastfeeding) as a critical component of optimal infant health; and which fully consider the impact of spillover mortality/morbidity associated with infant formulas.
• Epidemic management from a public health perspective, with the focus on primary prevention, careful, unbiased surveillance, and the achievement of overall population health with the lowest rates of morbidity and mortality.
• Evidence-based practices which protect the rights of both mothers and infants including education, true informed consent, support of a mother's choice, and avoidance of coercion.
• Funding to support the above actions and those programs which improve maternal/child health in general such as prenatal and postnatal care, nutrition, basic sanitation, clean water, and education, as well as exclusive breastfeeding until clear scientific evidence supporting the abandonment of breastfeeding is available.
• Continued commitment by local and global researchers, policy makers, health workers, and funding bodies to basic scientific, medical, public health, and fiduciary principles in responding to this critical issue.

In summary, we call for answers to critical questions not currently being addressed that will foster the development of policies and practices leading to the best possible outcomes for mothers and babies in relation to breastfeeding and HIV/AIDS.

Download the Call to Action in PDF format