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APHA Scientific Session and Event Listing

Recorded presentation

Ellen G. Piwoz, ScD¹, Wendy Johnson, MD, MPH², Cathrien Alons, MPH³, Martha Piedrasanta⁴, Lourdes Fidalgo⁵, Andre Briend, MD⁶, Katarina Regina, MD⁷, Florencia Floriano², Victorino Chivane³, and Ellen Warming³. (1) Center for Nutrition, Academy for Educational Development, 1825 Connecticut Avenue, NW, Washington, DC 20009, 202-884-8816, epiwoz@aed.org, (2) Health Alliance International, PO Box, Chimoio, Mozambique, (3) EGPAF, PO, Maputo, Mozambique, (4) Consultant, PO, Maputo, Mozambique, (5) ANSA, PO Box, Maputo, Mozambique, (6) Département Sociétés et Santé, IRD, PO Box, Paris, France, (7) Save the Children/US, PO Box, Maputo, Mozambique

Background: In Mozambique the dilemma of how to safely feed HIV-exposed infants cannot be taken lightly. Health worker advice to stop breastfeeding early places children from food insecure homes at increased risk of malnutrition and death. Methods: 67 mothers in HIV support groups and 70 mothers recruited from communities in Manica, Sofala, and Gaza Provinces were interviewed to obtain information on food security and infant diets focusing on the 6-12 month period. Local food prices were obtained via market surveys. Linear programming (LP) was used to identify the combinations of foods needed to meet the nutritional needs of non-breastfed infants at lowest cost. Results: Most HIV-positive mothers with infants > 6 mo said they had stopped breastfeeding (78%), whereas 90% of community mothers had not. LP indicates that commonly consumed local foods cannot meet the nutritional needs of non-breastfed infants in Gaza Province, where 52% of mothers reported current food shortage. In Manica and Sofala, diets are low in iron but could otherwise meet the nutritional needs of non-breastfed infants as long as animal milk, fruit, vegetables, dried fish, and beans are consumed daily along with staple foods. Replacing breast milk with local foods increases by 2-fold the estimated daily cost of feeding 6-12 month infants. Conclusions: Early breastfeeding cessation places vulnerable infants from food insecure households at increased risk of malnutrition. Specialized replacement foods and increased access to maternal ARV treatment are needed to protect the health and survival of HIV-exposed infants where food insecurity is endemic.

Learning Objectives:

• At the conclusion of this presentation, participants will recognize the risks of early breastfeeding cessation for HIV-exposed infants in food insecure settings and will be able to discuss the social and economic challenges that HIV-positive mothers face when taking decisions about infant feeding.

Keywords: Food Security, HIV/AIDS

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation