The 130th Annual Meeting of APHA

Abstract #43447

Kiersten A. Israel-Ballard, MPH¹, Nancy S. Padian, PhD², Tsungai Chipato, MD³, Zvavahera M. Chirenje, MD³, Caroline J. Chantry, MD⁴, Pamela Morrison, IBCLC⁵, and Livona Chitibura³. (1) Infectious Diseases, University of California, School of Public Health, University of California, 140 Earl Warren Hall #7360, Berkeley, CA 94720-7360, 510-531-0727, kiersten_ballard@yahoo.com, (2) Dept OB/GYN, Ctr for Reproductive Health Policy & Research, University of California, San Francisco, Box 0744, 3333 California Street, Ste. 335, San Francisco, CA 94143-0744, (3) Obstetrics and Gynaecology, University of Zimbabwe, UZ-UCSF Collaborative Women's Health Programme, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe, (4) Department of Pediatrics, University of California, Davis Medical Center, 2516 Stockton Blvd., Room 334, Sacramento, CA 95817, (5) Obstetrics, Avenue's Clinic, 10 Camberwell Close, Borrowdale, Harare, Zimbabwe

Abstract – The goal of this study was to determine the feasibility of expressing and heat-treating breastmilk as an alternative infant feeding option for HIV positive mothers in Zimbabwe. Heat-treating breastmilk by flash boiling or by Holder pasteurization through heating to 62.5° C for thirty minutes, has been documented to destroy HIV-1 proviral DNA while retaining a significant amount of maternal protection. Although the Zimbabwe Ministry of Health officially presents this alternative feeding method as a primary option to be considered by HIV positive mothers, it has yet to be implemented. This study was the first attempt to determine mothers’ attitudes regarding its feasibility.

Thirteen focus groups discussions (FGDs) were held with a total of seventy-seven participants in varying socio-economic levels to qualitatively identify the feasibility of this method for infant feeding. FGDs were conducted with mothers, fathers, grandmothers, and nurse midwives since each group had significant roles in the infant feeding decision making process. Manual expression of breastmilk was a well-known practice. Resources were not considered to be an obstacle since additional utensils would not be required. Most participants preferred the flash boiling method due to its visibility and brief preparation time. Potential obstacles included cultural perceptions of a mother not breastfeeding and the time required for the procedure. Success seemed dependent upon support from the husband and in-laws and community education. Overall this method was viewed as a practical alternative to formula feeding and should be included as an option for HIV positive mothers in Zimbabwe.

Learning Objectives:

• Recognize the need for alternative infant feeding options for HIV positive mothers in resource poor countries.
• Describe the method of manual expression and heat-treatment of breastmilk as an affordable and sustainable feeding option.
• Evaluate current feeding methods presented to mothers in developing countries and assess the practicality of this as an additional option.

Keywords: HIV Interventions, Breastfeeding

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.