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

suitable for replacement feeds before 6 months. Again, cup feeding is recommendedfor hygienic purposes.Recommendations for replacement feeding of children 6-24 monthsChildren of this age should be given a suitable breastmilk substitute andcomplementary foods (nutrient enriched and appropriately prepared family foods).Between 6 and 12 months breastmilk generally provides up to half or more of aninfant’s nutritional requirements, and between 12 and 24 months, up to one-third ofrequirements. If suitable breastmilk substitutes are not available, other dairyproducts should be given, such as animal milk, dried skimmed milk, yogurt, meat,liver, fish as a source of iron and zinc, and fruits and vegetables to provide vitamins(especially A and C).The guidelines for complementary feeding of children ages 6-24 months should becarefully adhered to for children given replacement feeds. Food quantity,consistency, and variety should increase as the child ages, while maintainingfrequent replacement feeds. Feeding frequency should also increase as the childages, using a combination of meals and snacks. Children 6-8 months old shouldreceive complementary foods 2-3 times a day, children 9-11 months old shouldreceive complementary foods 3-4 times a day, and children 12-24 months old shouldreceive complementary foods 4-5 times a day. It is also important to diversify thediet to improve quality and micronutrient intake. The mother or caregiver shouldpractice responsive feeding, frequent and responsive feeding during and afterillness, and good hygiene and proper food handling (LINKAGES 2001). See Session 8on nutritional care and support for children with HIV/AIDS, including care of severelymalnourished children, for additional information.Other breastmilk options• Breastmilk from breastmilk banks is generally available over a short time forsick or low birth weight babies, but not in limited-resource settings.• Wet nurses should be HIV negative. HIV transmission may occur from the infantto the wet nurse, especially if she has cracked nipples.203