The prevention of mother-to-child transmission (PMTCT) of HIV is a cornerstone of the global AIDS response. For decades, infant feeding choices have been central to PMTCT strategies, with World Health Organization (WHO) guidelines providing the normative framework for national programs. This article provides a comprehensive analysis of the implementation of WHO guidelines related to artificial feeding for HIV-positive women. It traces the evolution of these recommendations, from early policies favoring replacement feeding to the current era emphasizing antiretroviral therapy (ART) to make breastfeeding safe. The relevance of this topic lies in the immense operational challenges of translating global public health policy into safe, effective, and ethically sound practice at the local level. This paper utilizes a policy analysis and literature review methodology to examine the key components of the guidelines, the criteria for safe implementation (such as the AFASS conditions), and the documented outcomes and challenges from various settings. The results highlight a significant gap between policy and practice, influenced by factors such as healthcare system capacity, socioeconomic conditions, cultural norms, and the pervasive issue of stigma. While ART has shifted the paradigm, artificial feeding remains a critical option for a subset of women, and the lessons learned from implementing these guidelines are vital. The article concludes that successful implementation requires more than just guideline dissemination; it demands robust health systems, sustained investment, comprehensive provider training, and a steadfast commitment to a woman-centered, rights-based approach to care.