Promotion of breastfeeding is a key component of infant health policies globally. However, maternal HIV infection is a possible contraindication for breastfeeding since it can result in mother-to-child transmission. Research into infant-feeding strategies which will promote the health of all infants but also protect against HIV transmission is handicapped by technical difficulties in determining the exact timing of when an infant becomes infected. Nevertheless, progress is being made both in defining and promoting 'safer breastfeeding' for HIV-infected women who choose to breastfeed and in supporting the use of breastmilk substitutes by women who choose not to breastfeed. A common feature of all strategies is the need to optimize maternal health and support of women by midwives and other health care providers.