Table 5.

Available global and European countries’ breastfeeding guidelines

Guidelines	Country	Guidance on breastfeeding for mothers living with HIV
WHO (in collaboration with UNAIDS, UNFPA and UNICEF) (2010)	Global	• Mothers with HIV should be counselled about the risks and benefits of infant feeding and provided with specific guidance regarding their situation • Mothers who choose to breastfeed should be supported in their choice • Mothers who choose not to breastfeed should be provided with guidance and support around formula feeding • In low and middle income countries exclusive breastfeeding is recommended for the first six months of life
British HIV Association (BHIVA) and Children's HIV Association (CHIVA) (2010)	UK	• In the UK, mothers with HIV are recommended to refrain from breastfeeding from birth regardless of maternal viral load and ART • All mothers with HIV should be supported to formula feed their infant • In rare circumstances where a mother who is effective on combination ART with a repeatedly undetectable viral load chooses to breastfeed then maternal ART should be carefully monitored and continued until one week after all breastfeeding has ceased. Breastfeeding should be ceased by 6 months
Royal College of Obstetricians and Gynaecologists (RCOG) (2010)	UK	• All mothers with HIV should avoid breastfeeding • Women should be given supportive advice about formula feeding
DAIG and Österreichische AIDS-Gesellschaft (2011b)	Germany	• Mothers are advised not to breastfeed, according to WHO guidelines
Grupo de expertas y expertos del plan nacional sobre el sida y de gesida (2011)	Spain	• All mothers with HIV should avoid breastfeeding • Women should be given supportive advice about formula feeding • Formula is provided free of charge through the Public Health System
Ministero della Salute (2011)	Italy	• All mothers with HIV should avoid breastfeeding • Formula is provided free of charge through the National Health System
Prise en charge médicale des personnes vivant avec le VIH, France (2010)	France	• All mothers with HIV should avoid breastfeeding • Mothers with HIV should be counselled about the risks of breastfeeding and be given supportive advice about formula feeding