There have been numerous debates over the right choice between breast feeding and other substitutes in the conditions of mothers infected with HIV. Due to the possibility of infecting the infant with the virus, many women prefer bottled milk or other substitutes. However, unlike western countries where the issue of hygiene is no longer a problem, not even in the remotest corners of the countries, the situation is Africa is greatly related to the idea of a clean environment for women and their newborns. In this sense, the lack of financial possibilities determines the state and the population to be unable to provide a proper environment and to be unable to afford one respectively. Thus, the milk other than the maternal one is subjected to all sorts of bacteria, viruses, and even diseases. Therefore, on the one hand, there is the risk of the child to become infected with HIV; on the other hand, there is the great possibility of infants to get sick from alternative milk. These conclusions are the results of different tests which argue that "children exclusively breastfed to at least 3 months were less likely to be infected than those receiving mixed feeding before 3 months" (Coutsoudis, 2000)

On the other hand, in order to improve the supply of milk, breast milk is most of the times combined with animal milk and formula mils. This is largely the result of a precarious feeding system of the mature population, especially of pregnant women who do not benefit from any additional food supplies in order to insure that they are strong enough to produce natural milk. Therefore, they are often forced to dilute the quantity of breast milk with other types of milk. Specialists argue in this sense that "the worst thing the mother can do is mixed feeding, which means a bit of breast feeding, a bit formula feeding, because this is the worst condition we can have. (...) during the first two months of life, a bottle-fed baby is nearly six times more likely to die from diarrhea and a host of other infections than a breast-fed child. (...) contaminated water often is used in mixing the formula. (...) poor mothers often will dilute the infant formula with a lot of water to make it last longer. She says this provides the baby with fewer nutrients, leading to malnutrition" (Schlein, 2007).

The issue of malnutrition is a common topic for discussion in Africa at the moment because of the large numbers of children and adults faced with this situation. This is why most sources related to the issue of infant feeding take into consideration the situation in which children are underfed or suffer from malnutrition. However, it is a generally acknowledged fact the idea that breast feeding reduces the eventuality in which children may suffer from malnutrition, breast milk being the only resource available of vitamins for infants. However, the decisions which must be made by the mothers are rather limited and are done without knowing the full range of the consequences. Therefore, in order to reduce the risks of infants being infected with HIV through breast feeding, nut at the same time, to increase their chances of living in an infectious environment, action must be taken to educate the female population on the one hand, and to reduce the danger of infection on the other hand. More precisely, "When children born to HIV-infected women can be assured of uninterrupted access to nutritionally adequate breast milk substitutes that are safely prepared and fed to them, they are at less risk of illness and death if they are not breastfed. However, when these conditions cannot be met (...) artificial feeding substantially increases children's risk of illness and death. The policy objective must be to minimize all infant feeding risks and to urgently expand access to adequate alternatives so that HIV-infected women have a range of choices." (Latham...

In other worlds, one cannot decide whether it is more important to first create a proper and safer environment for children and only afterwards to create a program meant to reduce the lack of knowledge among African women. These two actions must be a combined initiative and should focus on the broader needs of infants and their mothers alike. More precisely, women and children, as well as the rest of the population should have access and should belong to an environment which is safe for their lives and their well being. In this sense, the international community should increase its efforts in aiding poor countries of the African continent. These actions include additional funding for health and food programs but at the same time it must take into account the initiatives held by the political forces in power in the respective countries. Taking into account the fact that a large part of the failure of the international community can be attributed to a lack of a stable political framework in those countries, it can be said that democratic governments with positive initiatives in this sense should be stimulated, while corrupt and failing governments should be sanctioned.
On the other hand, regardless of the environment they live in, the access to information is crucial in taking any decision. Therefore, women in Africa should be made aware of all the choices they have, with benefits as well as shortcomings. This would give them the opportunity to decide their children's future fully knowing the implication. It is rather clear that there needs to be an information and education campaign concerning breast feeding, the HIV risks, as well as other methods of feeding infants in Africa.

Overall, it can be concluded that the issue of food supplies, resources, the environment, and most importantly the condition of infants in Africa is worrisome. However, it is not irreversible. Solutions can be found in order to increase the awareness of women regarding infant feeding, and at the same time, as an adjacent measure, to create a future for the millions of children to be born in the next years in Africa.

Bibliography

Afolabi, et al. (2001) Malaria in the first 6 months of life in urban African infants with anemia. American Journal of Tropical Medicine and Hygiene, Vol 65, Issue 6, 822-827. Retrieved 26 March 2008, at http://www.ajtmh.org/cgi/reprint/65/6/822

Andersson, H. (2005). Niger's children continue dying. BBC News. Retrieved 26 March 2008, at http://news.bbc.co.uk/1/hi/world/africa/4274728.stm

Andersson, H. (2005). Niger children starving to death. BBC News. Retrieved 26 March 2008, from, http://news.bbc.co.uk/2/hi/africa/4695355.stm

Aneki (2008) Countries with the Highest Infant Mortality Rates in the World. Aneki Web page. Retrieved 26 March 2008, at http://www.aneki.com/mortality.html

Coutsoudis, a. (2000) Influence of infant feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa. Department of Paediatrics and Child Health, University of Natal, Congella, South Africa.

Digests. (2006) Starting Breast-Feeding Soon after Birth Lowers Infants' Risk of Neonatal Death. International Family Planning Perspectives, Vol. 32, No. 2. p. 102.

Latham, M. And Preble, E. (2000) Appropriate feeding methods for infants of HIV infected mothers in sub-Saharan Africa. Retrieved 26 March 2008, at http://www.bmj.com/cgi/content/full/320/7250/1656

Schlein, L. (2007) Study Finds Early Breastfeeding Can Save Babies' Lives. News on Voice of America. Retrieved 26 March 2008, at http://www.voanews.com/english/archive/2007-08/2007-08-01-voa8.cfm?CFID=214328461&CFTOKEN=53185992