The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3353.0: Monday, November 17, 2003 - 4:50 PM

Abstract #64656

Attitudes of HIV-positive mothers and the nurses who counsel them about WHO recommendations on HIV and infant feeding in Lilongwe, Malawi

Ellen Piwoz, ScD, Academy for Educational Development, 1825 Connecticut Ave., NW, Washington, DC 2009, Yvonne Owens Ferguson, MPH, Dept. of Health Behavior and Health Education, Univ. of North Carolina at Chapel Hill, 700-701 Laurel Springs Drive, Durham, NC 27713, 919-806-5603, Yvonne_Ferguson@unc.edu, Margaret E. Bentley, PhD, Nutrition, UNC-Chapel Hill, CB 7400, McGavran Greenberg, School of Public Health, Chapel Hill, NC 27514, Beatrice M. Mtimuni, PhD, University of Malawi, Bunda College of Agriculture, Lilongwe, Malawi, Amy Corneli, MPH, CHES, Health Behavior and Health Education, School of Public Health, University of North Carolina - Chapel Hill, 410 Fairoaks Circle, Chapel Hill, NC 27516, Agnes Moses, MBBS, UNC Project, Private Bag A-104, Lilongwe, Malawi, Linda S. Adair, PhD, Carolina Population Center, University of North Carolina at Chapel Hill, CB# 8120 University Square, 123 W Franklin St., Chapel Hill, NC 27516, and Charles M. van der Horst, MD, School of Medicine, University of North Carolina @ Chapel Hill, 547 Burnett-Womack Building CB#7400, Chapel Hill, NC 27514.

Counseling HIV-infected mothers on infant feeding options is challenging in resource poor countries such as Malawi. Current WHO guidelines recommend exclusive breastfeeding for the first 6 months. HIV-infected mothers are advised to avoid breastfeeding when replacement feeding is acceptable, feasible, affordable, sustainable and safe (WHO, 2001). Few studies have qualitatively examined HIV-infected women's views on these recommendations. As part of the formative research for the University of North Carolina and Centers for Disease Control and Prevention Safe Mother/Safe Babies clinical research protocol, we explored attitudes toward WHO infant feeding recommendations through in-depth interviews with 27 HIV-infected mothers and 19 nurses in Lilongwe, Malawi. Using a narrative story approach, most mothers indicated that they would avoid breastfeeding for fear of transmitting the virus to their infant if they could afford safe alternatives. Mothers were divided about their belief that breast milk alone provided adequate nutrients for their infants for the first six months. Mothers indicated that they would be willing to stop breastfeeding at 6 months if alternative foods were available. Most mothers stated that they would seek advice from a nurse to make an informed decision about their infant feeding options. Nurses were divided in their beliefs about whether HIV-infected mothers should breastfeed at all. Many nurses believed that it is difficult for women in their community to breastfeed exclusively for six months, and that women would be unable to stop breastfeeding at six months. Nurses also desired additional training in infant feeding counseling.

Learning Objectives:

Keywords: Breastfeeding, HIV/AIDS

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.

HIV and Social Attitudes

The 131st Annual Meeting (November 15-19, 2003) of APHA