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Fox EL, Pelto GH, Rasmussen KM, Debrosse MG, Rouzier VA, Pape JW, Pelletier DL. Who knows what: An exploration of the infant feeding message environment and intracultural differences in Port-au-Prince, Haiti. MATERNAL AND CHILD NUTRITION 2017; 14:e12537. [PMID: 28976068 DOI: 10.1111/mcn.12537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/27/2017] [Accepted: 09/09/2017] [Indexed: 11/28/2022]
Abstract
Worldwide, mothers with young children receive many messages about infant feeding. Some messages are generated by health providers and others by the households, communities, and social contexts in which women live. We aimed to determine the scope of infant feeding messages in urban Haiti and to examine intracultural differences in salience of these messages and their alignment with international guidelines. We applied the method of free listing with 13 health workers and 15 human immunodeficiency virus (HIV)-infected and 15 HIV-uninfected mothers with infants 0-6 months old at Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince, Haiti. Participants listed all messages women receive about infant feeding and specifically about HIV and infant feeding. Message salience was determined by frequency of mention and recall order; messages were coded for key themes. For all groups, the World Health Organization infant feeding recommendations were salient, especially those related to exclusive breastfeeding. Messages across all groups focused on infant health outcomes, with less emphasis on maternal outcomes. Cultural beliefs were also elicited and showed higher salience for mothers than health workers, particularly for consequences of poor maternal nutrition. Health workers' free lists were poorly correlated to those of mothers, whereas those of mothers were highly correlated, regardless of HIV status. Inasmuch as many salient messages were culturally generated, and differences existed between mothers and health workers, we conclude that it is important for health workers to acknowledge the broader infant feeding message environment, and discrepancies within that environment, to address successes and failures in the messages reaching mothers, given potential consequences for mothers' breastfeeding behaviours.
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Affiliation(s)
- Elizabeth L Fox
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.,Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gretel H Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | | | - Marie Guerda Debrosse
- Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haïti
| | - Vanessa A Rouzier
- Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haïti
| | - Jean William Pape
- Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haïti.,Center for Global Health, Weill Cornell Medical College, New York, New York, USA
| | - David L Pelletier
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
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Ghoma-Linguissi LS, Ebourombi DF, Sidibe A, Kivouele TS, Vouvoungui JC, Poulain P, Ntoumi F. Factors influencing acceptability of voluntary HIV testing among pregnant women in Gamboma, Republic of Congo. BMC Res Notes 2015; 8:652. [PMID: 26545975 PMCID: PMC4635544 DOI: 10.1186/s13104-015-1651-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 10/29/2015] [Indexed: 11/24/2022] Open
Abstract
Background This study was carried out to identify factors affecting the acceptability of voluntary HIV testing among pregnant women in a semi-rural city, Gamboma, Republic of Congo. Methods A cross-sectional study was conducted between January and September 2012. Pregnant women attending antenatal heath care at an integrated health center were enrolled after informed consent and followed through voluntary HIV testing. Results Among 136 participants, 98 women (72 %) accepted voluntary HIV testing after pre-test counseling. Women with basic education, those who cited blood transfusion as a mode of transmission and prevention of mother-to-child transmission (MTCT) were more likely to accept testing as well those informed about free HIV testing. Interestingly, pregnant women who had heard about HIV/AIDS from hospital setting were less likely to accept testing. Conclusions Our data indicate that increasing general education on HIV transmission/prevention modes is crucial for increasing acceptability of screening. Furthermore, HIV/AIDS knowledge disseminated to patients in hospital settings should be carefully monitored. Lastly, scaling-up MTCT services along with a better and larger community information, may address accessibility barriers observed in the present study.
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Affiliation(s)
| | - Dagene Fruinovy Ebourombi
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Anissa Sidibe
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Thomas Serge Kivouele
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Jeannhey Christevy Vouvoungui
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo. .,Faculty of Sciences and Techniques, Marien Ngouabi University, Brazzaville, Republic of Congo.
| | - Pierre Poulain
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo. .,Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo. .,Faculty of Sciences and Techniques, Marien Ngouabi University, Brazzaville, Republic of Congo. .,Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
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Nduna T, Marais D, van Wyk B. An Explorative Qualitative Study of Experiences and Challenges to Exclusive Breastfeeding Among Mothers in Rural Zimbabwe. ACTA ACUST UNITED AC 2015. [DOI: 10.1177/1941406414568562] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Breastfeeding is one of the most effective public health interventions known to reduce illness and deaths in infants and young children. While Zimbabwe has a breastfeeding culture, exclusive breastfeeding has remained low over the last decade. This study explored factors that enable and hinder exclusive breastfeeding in a rural district of Zimbabwe. Ten mothers and 5 key informants with breastfeeding experience were interviewed. Interviews were audiotaped, transcribed in Ndebele, translated into English, and analyzed using thematic analysis. Notable gaps still exist regarding mothers’ understanding of exclusive breastfeeding. Hunger, myths, and traditional beliefs around breastfeeding, as well as mixed and inconsistent messages regarding HIV/AIDS and breastfeeding, remain barriers to exclusive breastfeeding in the study area. Support from significant others, good nutrition for the breastfeeding mother, and knowledge about breastfeeding emerged as factors enabling exclusive breastfeeding. Messaging on breastfeeding and HIV/AIDS need to be consistent. Breastfeeding messages ought to be context specific, targeting custodians of tradition and belief systems, including men and significant others, to create a supportive and enabling environment for mothers to exclusively breastfeed. Whether hunger and differences in breastfeeding patterns between boys and girls affect infant feeding practices warrants further research.
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Affiliation(s)
- Themba Nduna
- Public Health Nutrition Research Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland (TN, DM)
- School of Public Health, University of the Western Cape, South Africa, Bellville, South Africa (BVW)
| | - Debbi Marais
- Public Health Nutrition Research Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland (TN, DM)
- School of Public Health, University of the Western Cape, South Africa, Bellville, South Africa (BVW)
| | - Brian van Wyk
- Public Health Nutrition Research Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland (TN, DM)
- School of Public Health, University of the Western Cape, South Africa, Bellville, South Africa (BVW)
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Goga AE, Doherty T, Jackson DJ, Sanders D, Colvin M, Chopra M, Kuhn L. Infant feeding practices at routine PMTCT sites, South Africa: results of a prospective observational study amongst HIV exposed and unexposed infants - birth to 9 months. Int Breastfeed J 2012; 7:4. [PMID: 22472507 PMCID: PMC3348038 DOI: 10.1186/1746-4358-7-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 04/03/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We sought to investigate infant feeding practices amongst HIV-positive and -negative mothers (0-9 months postpartum) and describe the association between infant feeding practices and HIV-free survival. METHODS Infant feeding data from a prospective observational cohort study conducted at three (of 18) purposively-selected routine South African PMTCT sites, 2002-2003, were analysed. Infant feeding data (previous 4 days) were gathered during home visits at 3, 5, 7, 9, 12, 16, 20, 24, 28, 32 and 36 weeks postpartum. Four feeding groups were of interest, namely exclusive breastfeeding, mixed breastfeeding, exclusive formula feeding and mixed formula feeding. Cox proportional hazards models were fitted to investigate associations between feeding practices (0-12 weeks) and infant HIV-free survival. RESULTS Six hundred and sixty five HIV-positive and 218 HIV-negative women were recruited antenatally and followed-up until 36 weeks postpartum. Amongst mothers who breastfed between 3 weeks and 6 months postpartum, significantly more HIV-positive mothers practiced exclusive breastfeeding compared with HIV-negative: at 3 weeks 130 (42%) versus 33 (17%) (p < 0.01); this dropped to 17 (11%) versus 1 (0.7%) by four months postpartum. Amongst mothers practicing mixed breastfeeding between 3 weeks and 6 months postpartum, significantly more HIV-negative mothers used commercially available breast milk substitutes (p < 0.02) and use of these peaked between 9 and 12 weeks. The probability of postnatal HIV or death was lowest amongst infants living in the best resourced site who avoided breastfeeding, and highest amongst infants living in the rural site who stopped breastfeeding early (mean and standard deviations: 10.7% ± 3% versus 46% ± 11%). CONCLUSIONS Although feeding practices were poor amongst HIV-positive and -negative mothers, HIV-positive mothers undertake safer infant feeding practices, possibly due to counseling provided through the routine PMTCT programme. The data on differences in infant outcome by feeding practice and site validate the WHO 2009 recommendations that site differences should guide feeding practices amongst HIV-positive mothers. Strong interventions are needed to promote exclusive breastfeeding (to 6 months) with continued breastfeeding thereafter amongst HIV-negative motherswho are still the majority of mothers even in high HIV prevalence setting like South Africa.
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Affiliation(s)
- Ameena E Goga
- Medical Research Council, Tygerberg& Pretoria, Pretoria Regional Office, 1 Soutpansberg Road, Pretoria, Private Bag x385, Pretoria 0001, South Africa
- Department of Paediatrics and Child Health, Kalafong Hospital, Pretoria, South Africa
| | - Tanya Doherty
- Medical Research Council, Tygerberg& Pretoria, Pretoria Regional Office, 1 Soutpansberg Road, Pretoria, Private Bag x385, Pretoria 0001, South Africa
- School of Public Health, University of the Western Cape, PB X17, Modderdam Road, Bellville, Cape Town 7535, South Africa
| | - Debra J Jackson
- School of Public Health, University of the Western Cape, PB X17, Modderdam Road, Bellville, Cape Town 7535, South Africa
| | - David Sanders
- School of Public Health, University of the Western Cape, PB X17, Modderdam Road, Bellville, Cape Town 7535, South Africa
| | - Mark Colvin
- Maromi Health Research, Inthuthuko Building (2nd Floor, HSRC), 750 Francois Rd, Durban, 4001, Private Bag X07, Dalbridge 4014, South Africa
| | - Mickey Chopra
- UNICEF New York, UNICEF House, 3 United Nations Plaza, New York, NY 10017, USA
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Columbia University, 630 W 168 Street, New York, NY 10032, USA
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Young SL, Mbuya MNN, Chantry CJ, Geubbels EP, Israel-Ballard K, Cohan D, Vosti SA, Latham MC. Current knowledge and future research on infant feeding in the context of HIV: basic, clinical, behavioral, and programmatic perspectives. Adv Nutr 2011; 2:225-43. [PMID: 22332055 PMCID: PMC3090166 DOI: 10.3945/an.110.000224] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about infant feeding in the context of HIV. Namely, we describe the benefits and risks of breastmilk, the evolution of recommended infant feeding modalities in high-income and low-income countries in the last two decades, and contextualize the recently revised guidelines for infant feeding in the context of HIV current knowledge. In the second section, we suggest areas for future research on the postnatal prevention of mother-to-child transmission of HIV (PMTCT) in developing and industrialized countries. We suggest two shifts in perspective. The first is to evaluate PMTCT interventions more holistically, to include the psychosocial and economic consequences as well as the biomedical ones. The second shift in perspective should be one that contextualizes postnatal PMTCT efforts in the cascade of maternal health services. We conclude by discussing basic, clinical, behavioral, and programmatic research questions pertaining to a number of PMTCT efforts, including extended postnatal ARV prophylaxis, exclusive breastfeeding promotion, counseling, breast milk pasteurization, breast milk banking, novel techniques for making breast milk safer, and optimal breastfeeding practices. We believe the research efforts outlined here will maximize the number of healthy, thriving, HIV-free children around the world.
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Affiliation(s)
- Sera L. Young
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94110,Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853,To whom correspondence should be addressed. E-mail:
| | | | - Caroline J. Chantry
- Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, 95817
| | | | | | - Deborah Cohan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94110
| | - Stephen A. Vosti
- Department of Agricultural and Resource Economics, University of California, Davis, CA 95616
| | - Michael C. Latham
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853
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Young SL, Israel-Ballard KA, Dantzer EA, Ngonyani MM, Nyambo MT, Ash DM, Chantry CJ. Infant feeding practices among HIV-positive women in Dar es Salaam, Tanzania, indicate a need for more intensive infant feeding counselling. Public Health Nutr 2010; 13:2027-33. [PMID: 20587116 PMCID: PMC3289716 DOI: 10.1017/s1368980010001539] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess feeding practices of infants born to HIV-positive women in Dar es Salaam, Tanzania. These data then served as a proxy to evaluate the adequacy of current infant feeding counselling. DESIGN A cross-sectional survey of infant feeding behaviours. SETTING Four clinics in greater Dar es Salaam in early 2008. SUBJECTS A total of 196 HIV-positive mothers of children aged 6-10 months recruited from HIV clinics. RESULTS Initiation of breast-feeding was reported by 95·4 % of survey participants. In the entire sample, 80·1 %, 34·2 % and 13·3 % of women reported exclusive breast-feeding (EBF) up to 2, 4 and 6 months, respectively. Median duration of EBF among women who ever breast-fed was 3 (interquartile range (IQR): 2·1, 4·0) months. Most non-breast-milk foods fed to infants were low in nutrient density. Complete cessation of breast-feeding occurred within 14 d of the introduction of non-breast-milk foods among 138 of the 187 children (73·8 %) who had ever received any breast milk. Of the 187 infants in the study who ever received breast milk, 19·4 % received neither human milk nor any replacement milks for 1 week or more (median duration of no milk was 14 (IQR: 7, 152) d). CONCLUSIONS Infant feeding practices among these HIV-positive mothers resulted in infants receiving far less breast milk and more mixed complementary feeds than recommended, thus placing them at greater risk of both malnutrition and HIV infection. An environment that better enables mothers to follow national guidelines is urgently needed. More intensive infant feeding counselling programmes would very likely increase rates of optimal infant feeding.
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Affiliation(s)
- Sera L Young
- Department of Pediatrics, University of California Davis Medical Center, Ticon II Building, Suite 334, 2516 Stockton Blvd, Davis, Sacramento, CA 95817, USA.
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Okong P, Namaganda PK, Bassani L, Tabaro MM, Zanetto F, Mwebaze EB, Weimer L, Tomasoni L, Castelli F, Giuliano M. Maternal HIV status and infant feeding practices among Ugandan women. SAHARA J 2010; 7:24-9. [PMID: 21409292 PMCID: PMC11132657 DOI: 10.1080/17290376.2010.9724952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
To describe the infant feeding practices in the general population in Uganda, and to assess the impact of maternal HIV status on these practices, a questionnaire was administered to women attending the follow-up clinics for child vaccination. Among the mothers who were still breastfeeding at the time of interview (N=838), 61.4% of the HIV-infected women had planned to breastfeed for a maximum of 6 months, compared with 12.1% of the HIV-uninfected women (p<0.001). Among the women who were not breastfeeding at the time of interview (N=108), 82.5% of the HIV-infected women had stopped breastfeeding within 3 months, compared with 23.5% of the HIV-uninfected women (p<0.001). Only 2.1% of HIV-infected women seen up to 14 weeks postnatally practised mixed feeding, compared with 23.6% of HIV-uninfected women (p<0.001). After 6 months, however, 30% of the HIV-infected women and 55% of the HIV-uninfected mothers were using mixed feeding, with no significant differences. Programmes for the prevention of mother-to-child transmission of HIV should re-enforce counseling activities to address the issue of early weaning by HIV-infected women, and to support safe breastfeeding up to 6 months.
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Affiliation(s)
| | | | | | | | | | | | - Liliana Weimer
- Unit of Pharmacology and Therapy of Viral Diseases of the Department of Therapeutic Research, Istituto Superiore di Sanità (The Italian National Institute of Health), Rome
| | - Lina Tomasoni
- Unit for Tropical and Imported Diseases, Spedali Civili General Hospital, Brescia
| | - Francesco Castelli
- Department for Mother and Child Care and Medical Biotechnologies, University of Brescia, Italy
| | - Marina Giuliano
- Unit of Pharmacology and Therapy of Viral Diseases of the Department of Therapeutic Research, Istituto Superiore di Sanità (The Italian National Institute of Health), Rome
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Msellati P. Improving mothers' access to PMTCT programs in West Africa: a public health perspective. Soc Sci Med 2009; 69:807-12. [PMID: 19539413 DOI: 10.1016/j.socscimed.2009.05.034] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2008] [Indexed: 11/17/2022]
Abstract
Despite technical means and apparent political will, the percentage of pregnant women involved in preventing mother-to-child transmission (PMTCT) interventions is not increasing as fast as public health authorities would expect. This is even more striking when compared to the scaling up of access to antiretroviral treatment. It seems important to analyze the successes and failures of the programs and the "scaling-up" of PMTCT programs. This is a major issue for women at two levels: women are very concerned about the health of their children, and they are the ones who implement prevention in collaboration with health services. A review of achievements and failures described from a public health perspective may lead to greater understanding of the social aspects involved in PMTCT program achievements and failures. This paper is based on the combination of a literature review and empirical evidence collected during 15 years of PMTCT implementation, childcare research and treatment programs in West Africa. The analysis aims to identify the social issues that explain the gap between PMTCT program aims and achievements in order to encourage research in the social sciences regarding relationships between mothers and the care system. We find it is possible to build programs at the national level that have a high degree of acceptance of testing and intervention, with a progressive decline in HIV infection among children. However, many obstacles remain, highlighting the necessity to broaden access to HIV screening, develop mass campaigns on testing for couples and improve HIV care and training for caregivers. Because HIV-infected pregnant women are experiencing great psychological distress, healthcare providers must use an approach that is as friendly as possible.
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Affiliation(s)
- Philippe Msellati
- IRD, UMR 145, IRD-Université de Montpellier/CreCSS, MMSH, 5 Rue du Chateau de l'Horloge, 13094 Aix en Provence cedex 2, France.
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Otoo GE, Lartey AA, Pérez-Escamilla R. Perceived incentives and barriers to exclusive breastfeeding among periurban Ghanaian women. J Hum Lact 2009; 25:34-41. [PMID: 18971507 PMCID: PMC4048713 DOI: 10.1177/0890334408325072] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Focus group discussions were conducted to elicit the perceived incentives and barriers to exclusive breastfeeding in Ghana. Thirty-five breastfeeding women were recruited from the Manya and Yilo Krobo districts of the eastern region. Participants had a mean age of 27.5 years and had at least one child < 4 months old. Almost all of the participants believed that exclusive breastfeeding is the superior infant feeding method and should be practiced for the first 6 months postpartum. However, there was widespread belief that infants can be given water if it is clean. Mothers reported that exclusive breastfeeding was easier when breast milk began to flow soon after delivery. The main obstacles to exclusive breastfeeding identified were maternal employment, breast and nipple problems, perceived milk insufficiency, and pressure from family. Addressing the concerns put forward by these participants can be used to enhance exclusive breastfeeding promotion in this region.
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Affiliation(s)
- Gloria E Otoo
- Department of Nutritional Sciences at the University of Connecticut, Storrs, CT 06269, USA
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Ogunlesi TA, Adekanmbi FA, Fetuga BM, Ogundeyi MM. Non-puerperal induced lactation: an infant feeding option in paediatric HIV/AIDS in tropical Africa. J Child Health Care 2008; 12:241-8. [PMID: 18678586 DOI: 10.1177/1367493508092511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A major problem in the management of infants exposed to HIV is the issue of feeding, which stems from the need to avoid transmission of the virus via breast milk. Other important issues in the nutrition of infants exposed to the virus include severe maternal illness, which makes suckling extremely difficult, and feeding orphans. Wet nursing is one of the recommended steps in addressing the feeding problems of such infants but for reasons of sociocultural disapproval, it appears not to be popular in traditional African settings. Non-puerperal induced lactation or re-lactation of a close relation, usually a grandmother, which hitherto has been used to rehabilitate severely malnourished motherless infants, may be equally useful. The procedure of re-lactation and the limitations of the method are highlighted. Also, the need to employ information, education and communication in improving the sociocultural acceptability of this veritable infant feeding method in tropical Africa is discussed.
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Affiliation(s)
- Tinuade A Ogunlesi
- Department of Paediatrics, Olabisi Onabanjo University and Consultant Neonatologist, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
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