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Feed me, Mama

Recently we released material about how mothers with HIV acquire formula milk in Great Britain and Russia. The material hit some hard spots. Here is…
ЗГМ ВИЧ

Recently we released material about how mothers with HIV acquire formula milk in Great Britain and Russia. The material hit some hard spots. Here is the second installment of the topic.
 
In October 2015, NP “E.V.A.” member Alena Tarasova from Neftyougansk (Khanty-Mansiisk Autonomous Okrug-Yugra (KhMAO)) gave birth to a daughter. Below is her story about the epic in attempting to receive formula milk in different regions:
 
“Knowing that breastfeeding is advised against, we purchased cheap formula in advance hoping that it would suffice and that in the future we could receive the formula for free. Unfortunately the inexpensive formula didn’t fare well for our infant and we had to purchase the formula that cost 600 rubles for one 350 gram can. One such can would last on average for 5 days.
 
One month later we went to our first doctor’s appointment to find out what we were to do to receive formula milk for free. In general KhMAO has a good system of supplying formula milk and it is given to everyone who does not breastfeed, regardless of the reason. However there is one significant “but”. In order to receive this benefit, the child must be registered and the according paperwork must be presented. My husband and I were registered in different cities and to receive the formula for our child in Neftyougansk, my husband and I had to travel together to the place of one of the parents and register the child there. This was nearly impossible since the child was an infant and travelling to another city in sub-zero temperatures was not wise. Therefore we bought the formula ourselves, which took up a huge chunk of the family budget considering that only my husband was working and we were renting our apartment. It was very hard. We were constantly haunted by the question: what if suddenly we did not have money to purchase formula for our child, what would happen?
 
When my daughter turned 6 months old, we moved to Tula, but also here we faced the issue of registration, and we also needed a doctor’s note and proof of our income because formula milk is only given to low income families. And the benefit itself is about 400 rubles a month, which is not enough to buy even one can of formula.
 
Therefore we could not fulfill the requirements and decided that when our daughter turned one and a half year old, I would stop receiving maternity benefits from work and then we could receive low income status.
 
For me the problem started with the supply of BMS after my daughter turned one year old. Usually one year old children eat practically everything. Despite that pediatricians recommend not to give cow’s milk, mothers often stop feeding formula to their infants in order to save money. We also decided to switch the formula for regular milk, but our daughter had problems with allergies. Therefore we had to continue to purchase formula. At that point it was a bit less expensive: the average can cost 400 rubles. And yes, the child drinks forumla a maximum of two times a day. But I must prepare porridge on the formula as well. And it is enough for 3-4 days on average. The benefit is about 400 rubles per month, which unfortunately is not sufficient for any mother.
 
I often meet HIV positive clients at consultations who are forced to give their newborns cow’s or goat’s milk and to boil porridge starting from the first month only because the mother doesn’t receive formula milk or if so, in an inadequate amount. The WHO does not recommend to feed infants less than 1 year milk, only formulas that have been specially developed for infants. Unfortunately this problem exists in many regions. I see only one solution: creating benefits for HIV positive mothers with a document that states that breastfeeding for them is proscribed without requiring any other documentation.”
 
NP E.V.A.’s recommendations from 2014 are still relevant today:
 
Many women are unaware of the possibility to receive BMS. Additionally, families in difficult financial situations often find it hard to speak about the inability to acquire the required amount of formula milk on their own to medical personnel or social workers. NP “E.V.A.” recommends that informational material be developed which will list all the subsidies and other opportunities granted by the subjects of the RF for pregnant women with HIV and women with HIV who have recently given birth. Informational material can be distributed in AIDS centers, infectious disease hospitals, regional gynecological offices, and social service centers.
 
Having information about possibilities of receiving formula milk for HIV positive mothers does not always mean that she can. NP “E.V.A.” recommends that a national system be created for low threshold access to milk formula for HIV positive mothers. For example: distribute formula at the maternity ward for the first several months of the infant’s life and then allow mothers to receive the formula at regional pediatric offices. NP “E.V.A.” is prepared to participate in the creation of the necessary normative documents. In numerous regions such systems are already in place. A partial solution to this problem could be centralization of formula milk purchase.
 
Half of women who receive BMS remark that the quantity provided was not enough to feed their child. NP E.V.A. recommends that upon purchase of formula, the average amount needed to feed a child for at least 6 months must be taken into consideration. According to the study, conducted by NP “E.V.A.” among HIV positive mothers in 2014, for the first 6 months of a child’s life, at least fifty six 350 gram packages of formula milk are needed.
 

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