Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice
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 compar...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The World Health Organization
2007-04-01
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862007000400014&lng=en&tlng=en |
| _version_ | 1797288622774288384 |
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| author | RM Bland NC Rollins HM Coovadia A Coutsoudis ML Newell |
| author_facet | RM Bland NC Rollins HM Coovadia A Coutsoudis ML Newell |
| author_sort | RM Bland |
| collection | DOAJ |
| description | 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 HIV-uninfected 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 HIV-negative women is minimal. |
| first_indexed | 2024-03-07T18:52:09Z |
| format | Article |
| id | doaj.art-2b8694e466a64648ad276d919726d109 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:52:09Z |
| publishDate | 2007-04-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-2b8694e466a64648ad276d919726d1092024-03-02T01:13:39ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862007-04-01854289296S0042-96862007000400014Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practiceRM Bland0NC Rollins1HM Coovadia2A Coutsoudis3ML Newell4UNIVERSITY OF KWAZULU NATALUNIVERSITY OF KWAZULU NATALUNIVERSITY OF KWAZULU NATALUNIVERSITY OF KWAZULU NATALUNIVERSITY OF KWAZULU NATALOBJECTIVE: 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 HIV-uninfected 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 HIV-negative women is minimal.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862007000400014&lng=en&tlng=en |
| spellingShingle | RM Bland NC Rollins HM Coovadia A Coutsoudis ML Newell Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice Bulletin of the World Health Organization |
| title | Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice |
| title_full | Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice |
| title_fullStr | Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice |
| title_full_unstemmed | Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice |
| title_short | Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice |
| title_sort | infant feeding counselling for hiv infected and uninfected women appropriateness of choice and practice |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862007000400014&lng=en&tlng=en |
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