Dr Violet Nabatte, an HIV specialist at Mildmay-Uganda, says in the past when HIV care and treatment was introduced, they were sceptical about newborns contracting the virus from their mothers during breastfeeding.
So, prevention was put at the forefront and mothers living with HIV were advised not to breastfeed their newborns. However, many parents lacked a good substitute for breast milk and consequently, the babies became malnourished.
Nabatte recalls that it was then that the World Health Organisation (WHO) introduced other guidelines, where the baby was introduced to a single dose of Nevirapine at birth and AZT for one week and then exclusively breastfed up to three months.
This necessitated mothers to start introducing porridges and other foods, leading to malnutrition and infections such as diarrhoea to which many children succumbed. It was upon that background that WHO introduced yet new guidelines termed as option B+.
“With the new guidelines, the baby is started on Nevirapine syrup at birth and taken up to six weeks while the mother adheres to ARVs and continues to breastfeed,” she explains.
After stopping the syrup at six weeks, Nabatte says the baby is tested and if found to be HIVnegative, the mother is encouraged to breastfeed exclusively for six months. Complementary feeding is introduced after six months while the mother continues to breastfeed while adhering to medication (ARVs).
The second confirmatory test is done at one year and when the baby is found to be HIV-negative, Nabatte says the mother is stopped from breastfeeding.