Tanzania National Strategy On Infant And Young Child Nutrition

This exciting book, edited by Fiona Dykes and Victoria Hall Moran and with a foreword from Gretel Pelto, explores in an integrated context the varied factors associated with infant and child nutrition, including global feeding strategies, cultural factors, issues influencing breastfeeding, and economic and life cycle influences

WHO and UNICEF jointly developed this global strategy to focus world attention on the impact that feeding practices have on the nutritional status, growth and development, health, and thus the very survival of infants and young children. The strategy is the result of a comprehensive two-year participatory process. It is based on the evidence of nutrition's significance in the early months and years of life, and of the crucial role that appropriate feeding practices play in achieving optimal health outcomes. The strategy is intended as a guide for action; it identifies interventions with a proven positive impact; it emphasizes providing mothers and families the support they need to carry out their crucial roles, and it explicitly defines the obligations and responsibilities in this regards of governments, international organizations, and other concerned parties.

Significant programmatic experience and research evidence regarding HIV and infant feeding have accumulated since WHO's recommendations on infant feeding in the context of HIV were last revised in 2006. In particular, evidence has been reported that antiretroviral (ARV) interventions to either the HIV-infected mother or HIV-exposed infant can significantly reduce the risk of postnatal transmission of HIV through breastfeeding. This evidence has major implications for how women living with HIV might feed their infants, and how health workers should counsel these mothers. Together, breastfeeding and ARV intervention have the potential to significantly improve infants' chances of surviving while remaining HIV uninfected. While the 2010 recommendations are generally consistent with the previous guidance, they recognize the important impact of ARVs during the breastfeeding period, and recommend that national authorities in each country decide which infant feeding practice, i.e. breastfeeding with an ARV intervention to reduce transmission or avoidance of all breastfeeding, should be promoted and supported by their Maternal and Child Health services. This differs from the previous recommendations in which health workers were expected to individually counsel all HIV-infected mothers about the various infant feeding options, and it was then for mothers to decide between them. Where national authorities promote breastfeeding and ARVs, mothers known to be HIV-infected are now recommended to breastfeed their infants until at least 12 months of age. The recommendation that replacement feeding should not be used unless it is acceptable, feasible, affordable, sustainable and safe (AFASS) remains, but the acronym is replaced by more common, everyday language and terms. Recognizing that ARVs will not be rolled out everywhere immediately, guidance is given on what to do in their absence.