Nutrition and HIV/AIDS: A Training Manual - Linkages Project

women with HIV/AIDS for additional information about counseling. Counseling oninfant feeding may be conducted during the VCT post-test session or in conjunctionwith MCH services. Peer counseling has been a successful approach in some PMTCTprograms.Program experience has shown that infant feeding options beyond breastfeeding areoften not feasible, sustainable, or socially acceptable. The following factors must beconsidered when discussing and counseling on infant feeding options with an HIVinfectedmother:• Nutritional requirements to avoid micronutrient deficiencies• Bacterial infections as a result of unclean water, unhygienic preparation andstorage, and the risk of diarrhea• Costs of formula, fuel, water, and health care• Family planning, including the lactational amenorrhea method (LAM) and othermethods. (LAM is a modern, temporary family planning method that supportsbreastfeeding and family planning use, which is based on the natural infertilityresulting from certain patterns of breastfeeding.)• Psychosocial stimulation through mother-infant bondingMany PMTCT programs, including the Ndola project, support informed choice by HIVinfectedmothers about their infant feeding decision. See Handout 6.1: WHORecommendations and Handout 6.2: PMTCT Decision-Making Algorithm.Safer infant feeding options (slides 30, 31)Note: Depending on students’ backgrounds, this complete description of safer infantfeeding options may be discussed before formative research and counseling.Once a thorough assessment has been made of the mother, household, andcommunity, the infant feeding options below may be discussed and evaluated fortheir feasibility and practicality. Food security issues must be considered for each of199