Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113564

Debra J. Jackson, BSN MPH DSC¹, Juana Willumsen, PhD¹, Ameena Goga, FC(Paeds)², Mickey Chopra, BSc, BM, DCH, MS³, Tanya Doherty, MPH⁴, Mark Colvin, MB ChB⁵, and Jonathan Levin, PhD⁶. (1) School of Public Health, University of the Western Cape, PO Box 16239, Vlaeberg, Cape Town, 8018, South Africa, 27-21-465-2243, bessrfam@iafrica.com, (2) Maternal Child and Women's Health and Nutrition, South Africa National Department of Health, Private Bag X828, Pretoria, 0001, South Africa, (3) HSRU, Medical Research Council, SOPH, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa, (4) Health Systems Trust, Riverside Centre, Main Road, Rondebosch, Cape Town, 7700, South Africa, (5) Cadre, 750 Francois Rd, Durban, 4001, South Africa, (6) Biostatistics Unit, Medical Research Council, 1 Soutpansberg Road, Pretoria, 0001, South Africa

BACKGROUND: While exclusive breastfeeding or replacement feeding is currently recommended for women in the South African national PMTCT programme, mixed feeding is the cultural norm. The capacity of participating mothers to exclusively feed their newborns is unknown. The aims of this study were to: 1) describe infant feeding patterns from birth to 9 months of HIV-positive and negative women, 2) describe the influence of the PMTCT programme on infant feeding, and 3) assess the capacity of mothers to maintain an exclusive feeding method. METHODS: This was a prospective cohort study of mothers and infants participating in three South African national PMTCT Programmes. Sites (Paarl, Rietvlei and Umlazi) were purposively selected to reflect different socio-economic, rural-urban and HIV prevalence regions. 662 HIV positive and 221 HIV negative mother-baby pairs were recruited antenatally or post-delivery. Data were collected by trained field staff using semi-structured interviews. Home visits were made at 3,5,7,9,12,16,20,24,28,32 and 36 weeks post-delivery. RESULTS: The simple infant feeding classifications commonly used in the HIV literature - exclusive breast, mixed, or exclusive replacement feeding - are not representative of the complex feeding patterns found in the cohort. A range of feeding patterns, rather than simple groups are necessary to accurately reflect the predominant feeding methods. This paper will discuss these patterns, how they differ across HIV+ and HIV- women, and their influence on child health and HIV transmission. CONCLUSIONS: Current infant feeding classifications used in the HIV literature are too simplistic to reflect infant feeding patterns in the context of HIV.

Learning Objectives:

• Understand issues concerning infant feeding in the context of HIV.
• Understand the risks of infant morbidity related to the different feeding patterns.
• Understand infant feeding in South Africa PMTCT programme.

Keywords: Breast Feeding, HIV Interventions

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation