© Pexels For women living with HIV, the decision to breastfeed comes with medical, emotional, and legal complexity. Although effective antiretroviral therapy (ART) significantly reduces the risk of HIV transmission, breastfeeding remains a debated issue, especially in countries with access to safe alternatives. A new European survey study, coordinated by WAVE under the European AIDS Clinical Society, looked at how national guidelines vary, how many women breastfeed, and what support is offered across 25 countries. The study revealed wide variations in policies—yet also a growing number of women living with HIV who choose to breastfeed. In many parts of the world, breastfeeding is both a cultural norm and a medical recommendation. For mothers living with HIV, however, this everyday choice becomes much more complicated. While the World Health Organization (WHO) supports breastfeeding alongside ART, most national guidelines in high-income settings continue to advise against it. These conflicting messages often leave women feeling unsupported or judged, especially when they wish to make informed, personal choices. This European survey explored national practices, trends, and laws regarding breastfeeding in women living with HIV. It gathered input from 25 countries, asking about guideline recommendations, current practices, and research activities. The aim was to understand how policies align with women’s real-life experiences—and to identify opportunities for better support.   A divided landscape with growing numbers of breastfeeding mothers Nearly half of the surveyed countries reported an increase in breastfeeding among women living with HIV. However, recommendations were split: 52% of countries advise against breastfeeding, while 48% allow it under strict conditions, such as undetectable maternal viral load. Notably, no country currently recommends breastfeeding as a routine option for all women living with HIV. In practice, however, some healthcare providers support women who choose to breastfeed, even when national guidelines discourage it. The study also found that maternal viral load monitoring, infant post-exposure prophylaxis, and education around breastfeeding vary widely between countries. Less than one-third of countries have dedicated staff to counsel women on this topic, and only a few provide clear patient information resources.   What this means for families and care providers For families navigating this decision, support depends heavily on where they live and which healthcare professionals they encounter. The study underscores the need for open, respectful conversations between providers and parents, acknowledging the emotional importance of breastfeeding while also addressing medical risks. A collaborative, informed approach can empower women to make safe, supported choices. This European-wide initiative will now help form a collaborative network focused on data sharing, research, and policy development. The goal is not only to fill knowledge gaps but to ensure that women living with HIV receive consistent, respectful care—no matter where they live.     Paper available at: Guidelines and practice of breastfeeding in women living with HIV—Results from the European INSURE survey – Keane – 2024 – HIV Medicine – Wiley Online Library Full list of authors: Keane, A.; Lyons, F.; Aebi-Popp, K.; Feiterna-Sperling, C.; Lyall, H.; Martínez Hoffart, A.; Scherpbier, H.; Thorne, C.; Albayrak Ucak, H.; Haberl, A. DOI: 10.1111/hiv.13583

When newborns require intensive care, closeness between parents and infants can be difficult to maintain—especially in traditional open bay units. Research has long suggested that skin-to-skin contact and physical presence are vital for a newborn’s development and for fostering the emotional bond with their parents. A recent Dutch cohort study explored whether switching from an open bay unit to single-family rooms could support more parent-infant closeness. Based on observations from over 800 families, the results show that architectural changes led to longer daily presence of both mothers and partners, and increased physical contact with their infants. While the transition had measurable benefits, the study also emphasizes that further improvements are needed to meet current care standards. When a newborn is admitted to a neonatal intensive care unit (NICU), the environment can either support or limit the connection between infants and their parents. In open bay units (OBUs), care is often efficient for staff but leaves little space for privacy, intimacy, or prolonged parental involvement. Emotional and physical closeness—like skin-to-skin care or holding—are essential to reduce stress, strengthen attachment, and promote healthy development in preterm or critically ill infants. To investigate how architecture influences this closeness, researchers followed families before and after a Dutch NICU transitioned from OBUs to single-family rooms (SFRs). These rooms allow parents to stay with their child throughout the day and night, offering more privacy and comfort. The study measured how often parents were present, how long they held their infants, and how much skin-to-skin contact occurred.   More time, more contact: A space that fosters bonding The results were clear: SFRs significantly increased parent-infant closeness. Mothers’ daily presence doubled, from about 3.5 hours in OBUs to 7 hours in SFRs. Partners showed a similar pattern, with their presence rising from 3 to 6 hours per day. Skin-to-skin care also improved—mothers increased from 2 to nearly 3 hours a day, and partners from under 2 to more than 2 hours. Lap holding saw smaller gains, mostly for mothers. These increases were consistent across all gestational age groups and started as early as the first day of life. The study highlights that while SFRs support stronger bonds, even with this improvement, parental presence fell short of WHO and GFCNI (former: EFCNI) recommendations. This suggests that room design alone is not enough—staff encouragement, flexible routines, and family-integrated care also matter.   Designing care that includes families For parents, these findings offer hope: the environment can support their presence and involvement, even in the stressful NICU setting. For hospitals and care teams, the study reinforces that investing in SFRs can enhance emotional and developmental outcomes. However, to fully support closeness, physical changes should be paired with cultural shifts that truly integrate parents into the care team. Encouraging closeness isn’t just about architecture—it’s about prioritizing family-centered care. This study adds to the growing evidence that where infants heal can shape how they connect.     Paper available at: Effect of Shifting From Open Bay to Single-Family Rooms on Closeness in a NICU – PubMed Full list of authors: Wielenga, J.M.; Pascual, A.; Ruhe, K.; Aarnoudse, C.; van Kaam, A.H. DOI: https://doi.org/10.1111/apa.70108

The postpartum period is a critical phase for both mothers and newborns, yet follow-up care remains inconsistent across healthcare systems. While global initiatives stress the importance of postpartum support, many women and infants do not receive adequate follow-up after leaving childbirth facilities. This gap in care can lead to undetected health complications, missed opportunities for intervention, and a lack of support for new mothers. A recent scoping review by researchers from the London School of Hygiene & Tropical Medicine examines different approaches to post-childbirth follow-up and their effectiveness.   Current methods of follow-up The study reviewed 31 research papers from high-, middle-, and low-income countries, identifying four main follow-up approaches used within the first 12 months postpartum: In-person visits – Conducted at home or in healthcare facilities, allowing direct medical assessment. Telephone calls – Used for checking maternal and newborn health, particularly in resource-limited areas. Self-administered questionnaires – Distributed by post or electronically to gather data on health outcomes. Hybrid models – Combining multiple approaches for better data collection and response rates.   Key findings and challenges The review found that post-discharge follow-up is feasible and important for identifying postpartum illnesses or complications that might otherwise be missed. However, it also highlights key challenges: Limited research on long-term postpartum complications, such as mental health issues and chronic pain. Gaps in cost-effectiveness analysis, with few studies reporting financial and resource implications. Low uptake of follow-up care in some regions, particularly where healthcare infrastructure is weak.   The need for better integration The findings suggest that structured follow-up could become an essential part of maternal and newborn healthcare, helping to detect complications early and provide timely support. However, more research is needed to evaluate the cost-effectiveness and sustainability of different follow-up methods. Healthcare providers and policymakers should consider integrating follow-up into routine care to improve maternal and neonatal health outcomes. This review provides a valuable resource for those involved in maternal and newborn health research, policy, and care provision. By strengthening post-childbirth follow-up, healthcare systems can address gaps in care and support the long-term well-being of mothers and newborns.   Paper available at: Current Approaches to Following Up Women and Newborns After Discharge From Childbirth Facilities: A Scoping Review – PubMed Full list of authors: Pepper, M.; Campbell, O. M. R.; Woodd, S. DOI: https://doi.org/10.9745/ghsp-d-23-00377