HIV epidemic and infant feeding in South Africa

Doherty, Tanya; Chopra, Mickey; Nkonki, Lungiswa; Jackson, Debra; Greiner, Ted

doi:10.2471/blt.04.019448

Cited by 143 publications

(91 citation statements)

References 13 publications

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“…The studies revealed that non-adherence was common among the mothers because of challenges relating to the individual mother, the family, the community, socio-economic factors, cultural factors and health care system constraints. 11,12,13 The studies were mostly done in rural and peri-urban areas in the Western Cape, Eastern Cape and KwaZulu-Natal provinces. Doherty et al 12 reported studies at three PMTCT of HIV sites in the three provinces whereby interviews with 27 HIV-infected mothers during the postpartum period revealed that just under half of the mothers who intended breast-feeding maintained exclusivity and over two-thirds of the mothers who initiated formula feeding maintained exclusivity.…”

Section: Discussionmentioning

confidence: 99%

The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

Ukpe

Blitz

Hugo

et al. 2009

South African Family Practice

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Purpose: To determine whether mothers attending a primary health care (PHC) clinic in the Mpumalanga province, South Africa for post-delivery prevention of mother-to-child transmission (PMTCT) of the Human Immunodeficiency Virus (HIV) follow-up care were adhering to the recommendation of exclusive infant-feeding practices, and to identify possible areas for improvement of the PMTCT of HIV services at the clinic.Setting: A municipal PHC clinic in White River, a semi-urban town in Mpumalanga, South Africa. Design:A cross-sectional descriptive study using a structured infant-feeding questionnaire.Subjects: All mothers attending the clinic for post-delivery PMTCT of HIV follow-up care during a four-month period from 1 November 2007 to 29 February 2008.Results: A total of 33 mothers with infants attended the clinic during the period. All 33 mothers took part in the questionnaire study. Thirty questionnaires were subsequently found suitable for analysis. The mothers were predominantly rural, with low levels of education and no formal employment. Their ages ranged from 22 to 42 years, with a mean of 30.7 years. Fifteen (50%) of the 30 mothers practised exclusive replacement feeding (ERF), 8 (27%) practised exclusive breast-feeding (EBF), and 7 (23%) practised mixed feeding. Conclusion:More than three-quarters of the mothers practised the recommended exclusive infant-feeding methods for PMTCT of HIV, with ERF as the most popular choice. However, the infant-feeding practices could not be generalised as the attendance of mothers for post-delivery follow-up care at the clinic was very poor during the study period. This poor attendance was attributed to frequent non-availability of free formula milk for the programme. Better quality counselling is needed to further increase the adherence to exclusive infant-feeding practices, and to improve the uptake of post-delivery follow-up care. A component of the PMTCT of HIV programme is the modification of infant-feeding practices during the postnatal period to reduce the risk of transmission of the virus through breast milk. [3][4][5][6] This advocates exclusive replacement feeding (ERF) or exclusive breast-feeding (ERB), and avoidance of mixed feeding or partial breast-feeding. 7 This study investigated the infant-feeding practices of mothers receiving post-delivery PMTCT of HIV follow-up care at a PHC clinic in the Mpumalanga province for the purpose of determining whether the mothers were adhering to the recommendation of exclusive infantfeeding practices, and identifying possible areas for improvement of the PMTCT of HIV services at the clinic. It was conducted at a municipal clinic in White River, a semi-urban town in the Lowveld region of the province. The clinic provides PHC services to the residents of the town and surrounding farming communities and rural areas. The clinic is also utilised by the Department of Family Medicine, University of Pretoria, for the training of student doctors in rural health. PMTCT of HIV services has been available at the clinic since...

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Section: Discussionmentioning

confidence: 99%

The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

Ukpe

Blitz

Hugo

et al. 2009

South African Family Practice

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“…1 However, mixed feeding rather than EBF, is associated with an increased HIV transmission risk 11 . HIV-positive mothers find it difficult to independently make decisions on infant feeding and are uncertain about the safety of breastfeeding 12 . Furthermore, in South Africa, health care workers have a great influence on a mother's infant feeding option, due to their role in the issuing of freeof-charge infant formula (up to March 2012).…”

Section: Maternal Medical Conditionsmentioning

confidence: 99%

Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province

MNutrition

Statistician²

2015

South African Journal of Clinical Nutrition

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“…This suggests that qualitative considerations (such as family acceptability, the practicalities of preparing replacement feeds or the fear of inadvertent disclosure of HIV status by avoiding breastfeeding altogether) were probably more important. 13,17,18 Only 32.1% of HIV-infected women had access to safe water, a fridge and adequate fuel for heating water. Most of these women (72%) still intended to exclusively breastfeed, suggesting that even access to regular finances or free infant formula for six months were not the main influences in their feeding decision.…”

Section: Discussionmentioning

confidence: 99%

Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice

Bland

Rollins

Coovadia

et al. 2007

Bull World Health Organ

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Objective To examine infant feeding intentions of HIV-infected and uninfected women and the appropriateness of their choices according to their home resources; and to determine their adherence to their intentions in the first postnatal week. Methods Feeding intentions of pregnant women were compared against four resources that facilitate replacement feeding: clean water, adequate fuel, access to a refrigerator and regular maternal income. First-week feeding practices were documented. Findings The antenatal feeding intentions of 1253 HIV-infected women were: exclusive breastfeeding 73%; replacement feeding 9%; undecided 18%. Three percent had access to all four resources, of whom 23% chose replacement feeding. Of those choosing replacement feeding, 8% had access to all four resources. A clean water supply and regular maternal income were independently associated with intention to replacement feed (adjusted odds ratio (AOR) 1.94, 95% confidence interval (CI) 1.2-3.2; AOR 2.1, 95% CI: 1.2-3.5, respectively). Significantly more HIV-infected women intending to exclusively breastfeed, rather than replacement feed, adhered to their intention in week one (exclusive breastfeeding 78%; replacement feeding 42%; P < 0.001). Of 1238 HIVuninfected women, 82% intended to exclusively breastfeed; 2% to replacement feed; and 16% were undecided. Seventy-five percent who intended to exclusively breastfeed adhered to this intention postnatally, and only 11 infants (< 1%) received no breast milk. The number of antenatal home visits significantly influenced adherence to feeding intention. Conclusion Most HIV-infected women did not have the resources for safe replacement feeding, instead choosing appropriately to exclusively breastfeed. Adherence to feeding intention among HIV-infected women was higher in those who chose to exclusively breastfeed than to replacement feed. With appropriate counselling and support, spillover of suboptimal feeding practices to HIVnegative women is minimal.

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HIV epidemic and infant feeding in South Africa

Cited by 143 publications

References 13 publications

The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province

Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice

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