Introduction Worldwide, 2.1 million of the estimated 33.4 million people living with HIV are children under 15 years of age and most live in sub-Saharan Africa . In contrast, data from the Collaborative HIV Paediatric Study (CHIPS) Report to the end of March 2009 confirm a total number of 1161 HIV-positive children currently alive and in active follow-up in paediatric HIV services in the UK and Ireland . These low overall numbers are primarily the result of well-structured and coordinated prevention of mother-to-child transmission (PMTCT) programmes. The programmes involve high uptake of antenatal testing, antiretroviral therapy (ART) for women in pregnancy, prophylaxis for the infant and the avoidance of breastfeeding . The result is a low HIV transmission rate of 2% to infants . Whilst the success of the PMTCT programme is clear, it is dependent on the financial support of national governments and is a picture seen largely, but not exclusively, in resource-rich countries. Prevention initiatives supported by governments in some developing countries have also produced favourable results. These include: the use of ART for the pregnant mother and exclusive breastfeeding with simultaneous maternal or infant ART for the duration of feeding . The World Health Organization (WHO) has revised its recommendations for HIV and infant feeding in resource-poor countries to reflect these initiatives but continues to strongly recommend formula feeding where it is safe to do so .