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...
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