ABSTRACT Background Donor human milk is the recommended alternative when a mother’s own milk is unavailable, especially for high-risk infants. Türkiye has no operational human milk bank, and the attitudes of actively breastfeeding mothers are poorly characterised. Aim To describe the knowledge, attitudes and concerns of actively breastfeeding mothers regarding human milk banks and to identify factors associated with their willingness to recommend one. Methods In this single-centre, cross-sectional study, 310 actively breastfeeding mothers with infants aged 0–6 months were recruited by consecutive sampling at a training and research hospital (March—May 2025). Data were collected using an interviewer-administered, 32-item questionnaire that was content-validated and piloted (not a formally validated scale). Associations were assessed with chi-square tests and binary logistic regression reporting adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results Only 37.1% of mothers were willing to recommend a human milk bank, 40.3% were unwilling and 22.6% undecided. Educational level was the only independent predictor of willingness to recommend (adjusted OR 1.59, 95% CI 1.15–2.20, p = 0.005); knowledge and employment were not significant after adjustment. Knowledge of milk banking was higher among mothers who were not employed (44.5% vs 14.5%, p < 0.001). Religious and moral concerns were prominent among those opposing a milk bank (21.9%, and the distribution of concerns differed significantly according to mothers’ views on establishment (p < 0.001). Conclusion Willingness to recommend was low but broadly consistent with international figures. Higher education was associated with greater willingness yet appears necessary rather than sufficient, as many reservations are religious or cultural. Expanding milk banking in Türkiye will require culturally sensitive engagement alongside public-awareness activities.

Nurses in the Swedish child health services conduct a home visit that focuses on newly-born infants. This video ethnographic study explores infant eating and breastfeeding as part of home visits, in a societal context characterized by involved fatherhood. Three examples from home visits allows us to discuss infant eating and the relevance of fathers for infants and breastfeeding mothers. Infants, who are breastfeeding, call for a type of involved fatherhood that is responsive to mothers and the needs and wants of infants. Taken together, our analysis outlines how agentic infants who eat implicates father-mother involvement and a collaborative approach to professional questions of infant eating and breastfeeding. This study adds to research on infant eating and parenthood by exploring home visits as a key situation in child health care.

Breast milk provides both short-term and long-term health benefits and is critical for infants admitted to neonatal intensive care units (NICUs). Presently, there is a large focus on increasing breastfeeding rates among Aboriginal and Torres Strait Islander women; however, culturally safe breastfeeding support is under-recognised and inadequately addressed in the NICU setting. This perspective highlights cultural and structural barriers and calls for urgent action to include the following four proposed strategies: strengthening the Aboriginal lactation workforce, embedding culturally inclusive education, partnering with community-controlled services, and developing a culturally specific NICU breastfeeding policy to improve outcomes.

Working from home (WFH) increased during the COVID-19 pandemic. The purpose of this study is to explore mothers' breastfeeding experiences of mutual responsiveness and perceived adequate milk supply in the breastfeeding relationship for the first 6 months after birth. Descriptive longitudinal qualitative design was used as part of a large study. Data were analyzed from a purposive sample of 25 breastfeeding mothers who returned to WFH within the first 6 months and directly breastfed their infant at least once a day for the first 6 months between June 2022 and August 2023. Inductive content analysis was used to analyze mothers' written responses to 4 open ended questions using an online survey, including breastfeeding experience at home, mothers' thoughts and feelings during direct breastfeeding, strategies used to resolve their breastfeeding problems, and breastfeeding support at work. Trustworthiness was attained by coding to consensus, peer debriefing, and maintaining audit trail. Changes in Breastfeeding Relationships When Mothers Return to Work from Home was the core construct and organized into three domains: (1) changes in breastfeeding when returning to work from home, (2) social support for breastfeeding continuation, and (3) maternal distress following return to work from home. For mothers juggling paid work while integrating direct breastfeeding with breast milk expression at home, it is recommended that nurses promote unrestricted direct breastfeeding when possible, including nighttime feeding, to sustain the breastfeeding relationship. This strategy will remain relevant in a postpandemic context.

Breastfeeding is the gold standard for infant nutrition, yet maternal stress and anxiety, especially in the Neonatal Intensive Care Unit (NICU) or due to postnatal pain, can inhibit the oxytocin-mediated milk ejection reflex, leading to reduced milk production and early cessation. Music intervention has been proposed as a non-pharmacological strategy to mitigate these stress responses. This systematic review and meta-analysis aims to evaluate the effect of music interventions on objective breastfeeding outcomes (milk volume and composition), salivary cortisol stress marker, and psychological well-being in breastfeeding mothers. Unlike previous studies, this review and analysis includes both term and preterm infants across diverse clinical settings and examines the impact of music on physiological (breast milk volume and composition, breastfeeding duration) and psychological outcomes (maternal stress and anxiety levels). A comprehensive search of Scopus, PubMed, CINAHL, and Web of Science was conducted for Randomized Controlled Trials (RCTs) published up to 2024. Following PRISMA 2020 guidelines, studies were selected based on their investigation of the effects of music on breastfeeding mothers. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool and GRADE framework for certainty of evidence. Data were synthesized both narratively and through meta-analysis where applicable. Six RCTs with a total of 696 participants met the inclusion criteria. Quality assessment confirmed that all trials somewhat adhered to protocols with "Some Concerns". Meta-analysis indicated that music significantly increased breast milk volume both immediately and cumulatively (Z > 1.96, p < 0.0001) with low heterogeneity (I² = 4%). Additionally, music improved breast milk fat content and reduced maternal salivary cortisol stress levels (Z > 1.96, p < 0.00001) with negligible heterogeneity (I² = 0%) respectively. The overall certainty of evidence is rated as "Moderate to Low," necessitating cautious clinical interpretation. This rating is primarily due to methodological heterogeneity in milk volume measurements, a lack of participant blinding, and the potential risk of publication bias. As one of the first reviews to concurrently assess both physiological and psychological breastfeeding outcomes, findings suggest music therapy is a promising, non-invasive adjunct to lactation care. By potentially reducing maternal stress, it may improve milk quantity and composition. However, further high-quality, standardized trials are necessary to carefully evaluate its true clinical magnitude and determine its appropriate integration into routine protocols for long-term breastfeeding success. Not applicable.

Breastfeeding support provided by healthcare professionals plays an important role in successful breastfeeding initiation and continuation. Previous studies have shown that breastfeeding-supportive maternity care and implementation of the Baby-Friendly Hospital Initiative (BFHI) are associated with improved breastfeeding outcomes and more positive maternal experiences [1, 2]. However, evidence regarding mothers' perceptions of breastfeeding support in Lithuania remains limited, and little is known about potential differences between Baby-Friendly and non-Baby-Friendly hospitals. The aim of this study was to evaluate maternal perceptions of breastfeeding support provided in Lithuanian maternity hospitals and to compare breastfeeding support between Baby-Friendly and non-Baby-Friendly hospitals. In addition, a secondary aim was to explore the internal structure of the newly developed questionnaire using exploratory factor analysis to facilitate interpretation of breastfeeding support domains. This cross-sectional comparative observational study was conducted in June 2022. Women (2-6 months postpartum) who had given birth to a healthy full-term infant in Lithuania completed an anonymous online questionnaire distributed via national social media parenting groups. Differences in breastfeeding support between Baby-Friendly and non-Baby-Friendly hospitals were analysed using descriptive statistics and appropriate statistical tests (Mann-Whitney U and χ² tests). Exploratory factor analysis was performed to examine the internal structure of the breastfeeding support questionnaire. A total of 572 women aged 18-45 years participated in the study; 65.7% delivered in a Baby-Friendly Hospital (BFH), and 76.2% were still breastfeeding at the time of the survey. Overall, breastfeeding support was evaluated as moderate, with a median total score of 65.0 out of 110 points (IQR 49-81). The highest-rated services were those provided by healthcare professionals (HCPs) during the first hours after childbirth (mean score 3.76 (SD 1.1) out of 5), while the lowest-rated were services related to HCPs' support for continued breastfeeding after discharge (mean score 2.40 (SD 1.0) out of 5). Most women reported that they had been given the opportunity for early breastfeeding and skin-to-skin contact; however, upon discharge, they received insufficient information from HCPs regarding peer support groups for breastfeeding mothers, the risks associated with the use of feeding bottles, pacifiers, and nipple shields, and the involvement of other family members in supporting breastfeeding. The evaluation of breastfeeding support and breastfeeding success were associated with hospital status - women who delivered in BFH rated the services more positively and were more likely to report continued breastfeeding compared to those who delivered in non-BFH (p < 0.05). Breastfeeding support in Lithuania is rated at a moderate level - women expressed satisfaction with early professional support following childbirth; however, they reported a lack of information and continuity of support to ensure successful breastfeeding at home. The findings indicate that delivery in BFH is associated with higher service ratings and greater breastfeeding success. These results highlight the need to strengthen the role of HCPs in providing ongoing breastfeeding support and to encourage hospitals to implement baby-friendly practices.

This study investigated whether breastfeeding (BF) is associated with a reduction in persistent hypertension (PH) and glucose metabolism impairment in patients with polycystic ovary syndrome (PCOS) who experienced pregnancy-induced hypertension (PIH) and/or gestational diabetes mellitus (GDM). This secondary observational analysis utilized data from two prospective cohort studies involving 241 participants (101 PCOS patients; 140 controls) with a history of GDM and/or PIH. At 18 months post-delivery, patients underwent physical examinations, blood pressure monitoring, and biochemical assays, including oral glucose tolerance tests. Feeding practices were categorized as exclusive BF, partial BF, or formula feeding (FF). Patients with PCOS demonstrated significantly shorter BF durations (9.6 ± 7.0 vs. 12.6 ± 5.9 months; P < 0.001) and lower exclusive BF rates (39.6% vs. 62.9%; P < 0.001) compared to controls. At 18 months, the composite cardiometabolic outcome prevalence was 55.4% in the PCOS group versus 11.4% in controls (P < 0.001). Multivariate analysis identified exclusive BF as a potent independent factor associated with a significantly lower risk (adjusted OR 0.14, 95% CI 0.05-0.38; P < 0.001) of cardiometabolic impairment. Breastfeeding is associated with a significant reduction in long-term cardiometabolic risks in women with PCOS following complicated pregnancies. Supporting and optimizing lactation may represent a valuable non-pharmacological strategy to consider for this high-risk population.

Codeine is commonly used in combination analgesic products. The use of codeine during breastfeeding can rarely be associated with serious adverse effects related to genetic polymorphisms affecting codeine's metabolism and disposition. Clinicians treating infants of breastfeeding mothers should be aware of this rare but potentially serious complication.

The B vitamin family of nutrients includes folates; a crucial group of nutrients obtained from food. Folate deficiency is a major concern in Ghana, and the resultant neural tube defects in newborns are rampant, but no surveillance is in place. Dietary approaches have proven more sustainable; therefore, this study aimed to conduct a community survey among women to assess the intake of dark green leafy vegetables (DGLV) and to quantify the folate content in a variety of DGLV frequently consumed in Accra, Ghana. A cross-sectional study of 388 pregnant and nursing mothers aged 15 to 49years in Dodowa, an Accra district, was conducted to analyze their consumption of green leafy vegetables using structured questionnaires. The study also looked at the folate levels of various green leafy vegetables that are widely consumed in Ghana. The Kolmogorov-Smirnov test was used to assess the normality of continuous variables. A variance analysis with a post hoc test was used to see whether there were differences in the means of the readings between samples. A general low intake of folate-rich vegetables in terms of both frequency per week and quantity consumed was recorded. Kontomire emerged as the most frequently consumed DGLV, with 36.1% of participants reporting weekly intake and 24.5% consuming it three times weekly. In contrast, vegetables such as Gboma, Bokobokor, and Alefu were rarely consumed. Over 87% of participants reported never eating Gboma, while 91.5% and 94.3% never consumed Bokobokor or Alefu, respectively. Folate content in vegetable samples ranged between (44.36 ± 17.37 to 220.39 ± 21.93) ug/100g and (33.53 ± 9.27 to 122.06 ± 5.19) ug/100g for fresh and steamed (3min) samples, respectively. Although the green leafy vegetables studied were found to be rich in folates, steaming led to considerable losses ranging from 8.56 to 78.46%. The results suggest that raw vegetables may offer higher levels of folate, compared to cooked vegetables. The community survey reported limited consumption of vegetables rich in folate. These findings expand knowledge on neural tube defects, orofacial clefts, and folate content in Ghanaian foods, offering a foundation for future public health measures and policy.

Sleep is marked by ultradian cycles coinciding with the alternation of rapid eye movement (REM) and non-rapid eye movement (NREM) sleep. These sleep cycles are a striking feature exhibited from infancy through adulthood, yet their underlying mechanisms and functional relevance remain elusive, calling for large-scale longitudinal studies. Here we leverage Locomotor Inactivity During Sleep (LIDS), an accessible marker of sleep cycles in adults, to chart ultradian sleep cycle dynamics in infants at scale. Specifically, we analyzed $>35,000$ hours of sleep from a longitudinal dataset of $152$ infants with actigraphy at 3, 6, and 12 months of age. Using complementary signal processing techniques, we demonstrate the existence of rhythmic patterns in infant LIDS with cycle lengths of $\sim 60$ minutes. Cycles were shorter in infants than parents (62 min 95%CI $[56,67]$ vs. 81 min $[74,88]$) and increased by $\sim 10$ min from $3$ to $12$ months, mirroring previous results in smaller samples for NREM-REM sleep cycles. This increase was partially mediated by increasing sleep bout duration ($1.0$ min/h $[0.9,1.2]$). Longer cycles were also found in infants still breastfed at $12$ months ($+2.5$ min $[0.4,4.5]$) and their breastfeeding mothers ($+6.7$ min $[0.5,12.9]$). Furthermore, inactivity was lower at sleep onset, declined more rapidly and showed a greater amplitude in infants than parents, but all three parameters began to mature already within the first year. Overall, our results support a link between patterns in limb inactivity and sleep cycle physiology in infancy, underscoring the potential of studying these in large-scale cohorts for developmental and health outcomes.

The Free Nutritious Meal Program (MBG) is a government initiative designed to improve community nutrition, particularly among students, toddlers, pregnant women, and breastfeeding mothers. Public responses to this policy have been widely expressed through social media platforms, including TikTok, where comments are often brief, informal, and unstructured. This study aims to classify public sentiment toward the MBG program into positive, negative, and neutral categories using the Support Vector Machine (SVM) algorithm and to evaluate the model’s performance. Data were collected through TikTok comment crawling techniques, resulting in 2,777 comments, of which 2,602 were retained after data cleaning. The preprocessing stages included text cleaning, case folding, normalization, tokenization, stopword removal, and stemming using the Sastrawi library. The dataset was divided into training and testing data with an 80:20 ratio, followed by TF-IDF feature extraction and SVM-based classification. Model performance was evaluated using accuracy, precision, recall, F1-score, and a confusion matrix. The results indicate that the SVM algorithm effectively classified public sentiment regarding the MBG program and successfully identified sentiment distribution patterns. These findings provide valuable insights into public perceptions of the program and contribute to the development of machine learning-based sentiment analysis for public policy evaluation in Indonesia.

Given the functional, emotional, and symbolic challenges imposed by cleft lip and/or palate (CL/P) on exclusive breastfeeding (EBF), mothers often experience early breastfeeding cessation with impacts on maternal identity and the mother-infant bond. This study aimed to explore the meanings, feelings, and experiences of mothers of children with CL/P regarding breastfeeding in the face of these adversities. This qualitative study applied the Clinical-Qualitative Method as proposed by Turato. Six in-depth semistructured interviews were conducted with biological mothers of children with CL/P, recruited from a specialized craniofacial reference center in Brazil. Data were analyzed using a qualitative content analysis approach, grounded in psychodynamic concepts from the Medical Psychology theoretical framework. Based on the analysis of the collected material, three analytical categories were identified and constructed: (1) "Existential conflict regarding the inability to fulfill the ideal maternal role"; (2) "Duality between the need and the fear of caregiving"; and (3) "The anguish experienced between tangible and intangible support during breastfeeding."Conclusions:Although the inability to EBF in children with CL/P generates emotional distress, motherhood is reimagined through adaptive forms of care and bonding, highlighting gaps in institutional support and the need for more humanized, emotionally sensitive health practices.

The purpose of the current study was to assess the effect of couple counseling on maternal distraction and attention levels during breastfeeding and nonfeeding childcare in mothers experiencing distractions in Hamadan, western Iran. In this randomized controlled trial, mothers attending comprehensive health centers for routine postpartum care who reported distraction during breastfeeding were enrolled. Participants were assigned via block randomization to an intervention group (standard care plus couple-centered counseling) or a control group (standard care alone). The maternal distraction was measured using the maternal distraction questionnaire at baseline, immediately post-intervention, and at two-, three-, and 4-month follow-ups. The analysis included 64 participants in each group. At 4 months, 40.6% more mothers in the intervention group than in the control group reported not being at all distracted during breastfeeding, with a 36% difference in favor of the intervention group for very high attention. Corresponding figures during childcare were 42.2% and 37.5%, respectively. A significant interaction between time and group was observed for both maternal distraction during breastfeeding and during childcare (p < 0.001). In the intervention group, maternal distraction during breastfeeding decreased from 17.89 ± 2.53 at baseline to 8.31 ± 1.27 at 4 months, and during childcare from 18.03 ± 1.94 to 8.98 ± 2.06. In the control group, these scores decreased only slightly, from 16.84 ± 2.50 to 15.52 ± 2.37 for breastfeeding and from 17.84 ± 2.44 to 15.19 ± 2.29 for childcare. Our study showed that a couple-centered counseling intervention significantly reduced maternal distraction and improved attention during breastfeeding and childcare.

The prevalence of breastfeeding in disabilities: A systematic review and meta-analysis.

Hand expression (HE) of breast milk enables milk collection at any stage of lactation. Its use is widely recommended for breastfeeding mothers. However, evidence surrounding utilization, outcomes, and experiences using HE is limited. This scoping review aims to broadly examine the literature describing patient and health care provider experiences, utilization, and clinical outcomes of HE of breast milk. We conducted systematic searches in MEDLINE, Embase, Web of Science, Scielo, and DialNet. We included both primary research and quality improvement reports. Four reviewers screened all papers for eligibility, read the full text of included studies, and extracted data. Of the 620 reports identified, 118 studies from 30 countries met eligibility criteria. Studies found high rates of familiarity with HE but variable rates of use. Most women expressed favorable views and experiences with HE. Multiple successful methods of teaching HE to lactating women and health care professionals were described. Many studies report teaching HE within wider interventions, such as antenatal milk expression programs and initiatives to increase breastfeeding among preterm infants. Most reports of breastfeeding outcomes, breast milk volume, and constituents gave mixed results, although HE in the first days postpartum was often associated with improved outcomes. No studies were found testing the use of HE for particular breast conditions such as mastitis or hyperlactation. While HE is generally favorably experienced by women and health care providers and may improve breastfeeding outcomes, further research is needed on HE as a primary exposure to better apply it in clinical lactation management.

Infant postnatal prophylaxis (PNP) is universally recommended for all breastfed infants born from mothers living with HIV up to 6-weeks of age. Continuation of PNP was recommended for infants defined as at high-risk of HIV acquisition. We hypothesised that a single maternal viral load (mVL) at the end of the universal PNP period can accurately identify infants requiring extended prophylaxis. We assessed 1398 VL of breastfeeding mothers from Zambia and Burkina Faso at baseline (week 6-8), months 6 and 12 post-partum. Infants were defined at high-risk of HIV acquisition when mVL was ≥ 1000 cp/mL. Mothers with a VL between 40 and 1000 cp/mL or ≥ 1000 cp/mL at baseline were 6 [95CI 3.7-9.6] or 18 [95CI 12.6-25.7] times more likely to have a VL above 1000 cp/mL during breastfeeding than mothers with a VL below 40 cp/mL. A 40 cp/mL threshold for mVL showed a better performance to identify infants eligible for extended PNP in comparison with the standard threshold. A single mother VL at W6-8 enabled a sensitive identification of infants at risk of HIV acquisition throughout the breastfeeding period. This conclusion may pave the way for a simplified risk-stratified guideline for the initiation of extended infant PNP.

The purpose of this cross-sectional study was to investigate knowledge about multiple-birth families among midwives and public health nurses working in maternity and child health clinics in Finland. The data were collected with a Finnish language questionnaire in spring 2022. Because relevant questionnaires did not exist, we created a new questionnaire based on existing knowledge and practices. The questionnaire assessed three themes of multiple-birth knowledge relevant for the target population. The response rate was 50% and the number of respondents was 72. A total of 92 items were assessed and these showed high levels of consistency within themes. The respondents had substantial variation in their levels of multiple-birth family knowledge concerning different themes (Kruskal-Wallis test, p < .001). Post-hoc pairwise comparisons revealed many significant differences between themes, the two themes of knowledge of speech development of twins and breast feeding having the lowest level of knowledge, while interaction and support expected by the parents having the highest level of knowledge. The respondents had good knowledge of only five themes of multiple-birth family knowledge. Of all the themes, only knowledge about breast feeding was not significantly related to other themes, except for a weak correlation (r = .264, p < .05) with knowledge about caring for twins and understanding the situation. The age, educational level and work experience of respondents did not significantly affect their scores (all p > .1). Although the respondents had knowledge about early interaction, bonding and supporting the growth and development of child, its application is insufficient or lacking because of the special needs of multiple birth families. Further research is required on the effectiveness of training interventions and on nursing in different nursing contexts.

Despite overwhelming evidence of the benefits of breastfeeding (BF) and its potential to decrease infant mortality, BF rates are low in many low- and middle-income countries like Ghana. We sought to assess Ghanaian mothers' BF plans and their rationale for these plans. We conducted a mixed method study via face-to-face interviews administered in 2019. We included pregnant or recently delivered maternity ward patients at a tertiary care center in Kumasi, Ghana. Semi-structured interviews were conducted to collect sociodemographic information, BF plans, and reasons for BF preferences. In accordance with World Health Organization recommendations, optimal BF was defined as 6 months of feeding an infant with breastmilk only (exclusive BF) followed by at least 18 months of feeding an infant the combination of breast milk and supplementary liquids and/or solid foods (complementary BF). Demographic characteristics of the cohort were compared by maternal BF plan using Pearson's chi-squared and t-test. Simple thematic analysis was performed to identify reasons for BF preferences. During the study period, 126 participants were enrolled. Forty-two (33.3%) participants planned to practice optimal BF. Participants who were married were more likely to have optimal BF plans than unmarried participants (OR 0.17; 95% CI 0.04, 0.53). There was no association between optimal BF plans and age, education, religion, and pre- or post-delivery status. Reasons for not practicing optimal BF included concern about the nutritional sufficiency and infants' enjoyment of breastmilk, logistical challenges of optimal BF, milk underproduction, and medical concerns for mother or baby. Only one-third of our cohort planned to practice optimal BF. Strengthening family support systems and improving patient education may increase optimal BF rates in Ghana.

Mercury exposure in breastfeeding mothers and associated health risks to infants: Evidence from breast milk and nail biomarkers.

Since the mid-1990s, there have been major advances in diagnosing and providing antiretroviral therapy (ART) for pregnant women living with HIV (WLWH) in both resource-rich and resource-limited settings. Initial progress was based on the 1994 landmark perinatal trial, which showed 67% reduction in vertical transmission among infants born to non-breastfeeding mothers in the United States when zidovudine was given during pregnancy, at labour/delivery and for 6 weeks after birth. International perinatal trials began testing "short-course" zidovudine regimens during late pregnancy and at labour/delivery to develop cost-effective, feasible and deliverable interventions for low-resource environments. More recent research has focused on the delivery of cost-effective combination triple ART during pregnancy and breastfeeding for WLWH. The latest trial results indicate that providing lifetime maternal ART at the time of antenatal diagnosis improves overall survival and decreases morbidity, while reducing vertical transmission to <1%. Translation of clinical trial results into successful widescale programme implementation remains a major challenge, particularly in low- and middle-income countries with high HIV seroprevalence and weak maternal and child health infrastructure. Interventions recommended earlier in the global epidemic are no longer adequate, but key points of the perinatal cascade of services remain crucial to both ensure successful HIV care for WLWH and maximize reductions in vertical transmission. Notable progress made in Botswana and Uganda is valuable to highlight country-led successes. Rapid HIV testing for pregnant women whose status is unknown, followed by immediate implementation of lifetime maternal ART, and linkage to long-term HIV care/treatment are essential. Counselling on adherence, as well as the use of long-acting ART regimens and holistic support for women's care, including psychosocial support, are also needed. A current major challenge has been the sudden reduction in international donor funding, which has had a significant negative impact on continuity and effective delivery of HIV care/treatment services. Much progress has been made in advancing HIV interventions and programmes for WLWH and pregnant and breastfeeding mothers. However, several challenges persist, which compromise delivery of effective interventions on the path to eliminate perinatal HIV transmission, and care/treatment remains suboptimal for WLWH, especially in resource-limited settings.