Abstract
This chapter discusses the dilemma that is at the heart of the debate around infant feeding policies for human immunodeficiency virus (HIV)-infected women. The dilemma arises because HIV infection can be transmitted via breastfeeding and, at the same time, avoidance of all breastfeeding is associated with increased risk of infant and young child morbidity and mortality. Risk–benefit models that have quantified expected outcomes with different infant feeding options are discussed. The role of exclusive breastfeeding, early weaning, and socioeconomic contextualization of risk in the infant feeding policy debates are discussed. It has now been shown that antiretroviral drugs given either to mothers or to infants can substantially reduce risks of postnatal HIV transmission. The availability of antiretroviral interventions was able to transform the policy arena and lead to greater support for breastfeeding for HIV-infected women.
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