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Peer Reviewed

Title: Breastfeeding duration related to practised contraception in the Netherlands.
Author: van Wouwe JP; Lanting CI; van Dommelen P; Treffers PE; van Buuren S
Source: Acta Paediatrica. 2009 Jan;98(1):86-90.
Abstract: AIM: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. METHODS: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of the time interval between resuming contraception and cessation of lactation was calculated by Chained Equations Multiple Imputation. RESULTS: Of all women (n = 2710), 30% choose condoms, 22% the combined oral contraceptive pill (OCP) and few other methods. Breastfeeding was started by 80%, and 18% continued up to 6 months. Of the breastfeeding mothers, 5% used hormonal contraception; 7% of women who used hormonal contraception practised breastfeeding. After adjustment for background variables, the use of OCP is strongly associated with formula feeding: after delivery to the third month postpartum, the crude OR being 17.5 (95% CI: 11.3-27.0), the adjusted OR 14.5 (9.3-22.5); between the third and sixth month postpartum, respectively, 13.1 (95% CI: 8.6-19.9) and 11.7 (7.6-17.9). Of all breastfeeding women, 20-27% resumed OCP at 25 weeks postpartum and 80% introduced formula feeding. The time lag between these events is 6 weeks. Hormonal contraception was resumed after formula introduction. CONCLUSION: Mothers avoid hormonal contraception during lactation; they change to formula feeding 6 weeks before they resume the OCP. To effectively promote longer duration of breastfeeding, the BFHI needs to address contraception as practised.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | QUESTIONNAIRES | MOTHERS | INFANT | BREASTFEEDING | BOTTLE FEEDING | TIME FACTORS | CONTRACEPTION CONTINUATION | LACTATION | Europe, Western | Europe | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Population Dynamics | Contraceptive Usage | Contraception | Family Planning | Maternal Physiology | Physiology | Biology
Document Number: 330861

Title: Understanding child feeding practices of Vietnamese mothers.
Author: Babington L; Patel B
Source: MCN. American Journal of Maternal Child Nursing. 2008 Nov-Dec;33(6):376-81.
Abstract: PURPOSE: To understand the feeding practices, knowledge, and nutritional beliefs of Vietnamese mothers with young children who are recent immigrants to the United States. STUDY DESIGN AND METHODS: Exploratory, descriptive study using a focus group design to provide qualitative data. Twelve Vietnamese mothers of children under the age of 5 years participated in a 1-hour focus group discussion (in Vietnamese) facilitated by a Vietnamese nutritionist and the principal investigator. RESULTS: The study participants identified that breastfeeding is healthier for babies than formula but reported the difficulty in maintaining breastfeeding due to work and family constraints. A traditional Vietnamese diet of meat or fish with soup broth, vegetables, and rice was the preferred and healthiest diet for children under the age of 6 years. There was consensus in the group that "junk food" and inactivity were unhealthy for children and led to overweight and obesity. Several of the group participants verbalized difficulty in maintaining a healthy diet for their children because the children demanded unhealthy food choices, and their work schedules made it difficult to make sure their children were getting adequate exercise. CLINICAL IMPLICATIONS: This knowledge can be used by nurses to develop culturally appropriate interventions for immigrants from Vietnam aimed at preventing childhood obesity. Interventions that consider the effects of acculturation could be more effective when targeted to parents of young children than interventions focused on treatment of obesity in later years.
Language: English
Keywords:
VIETNAM | UNITED STATES OF AMERICA | SUMMARY REPORT | IMMIGRANTS | MOTHERS | YOUTH | CHILD NUTRITION | BELIEFS | KNOWLEDGE | BREASTFEEDING | BOTTLE FEEDING | EVALUATION | Asia, Southeastern | Asia | Developing Countries | Developed Countries | North America | Americas | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Age Factors | Population Characteristics | Nutrition | Health | Culture | Infant Nutrition
Document Number: 330208

Peer Reviewed

Title: HIV, infant feeding and more perils for poor people: New WHO guidelines encourage review of formula milk policies.
Author: Coutsoudis A; Coovadia HM; Wilfert CM
Source: Bulletin of the World Health Organization. 2008 Mar;86(3):210-214.
Abstract: The release of the new WHO guidelines on HIV and infant feeding, in a global context of widespread impoverishment, requires countries to re-examine their infant-feeding policies in relation to broader socioeconomic issues. This widening scope is necessitated by compelling new reports on the scale of global underdevelopment in developing countries. This paper explores these issues by addressing feeding choices made by HIV-infected mothers and programmes supplying free formula milks within a global environment of persistent poverty. Accumulating evidence on the increase in malnutrition, morbidity and mortality associated with the avoidance or early cessation of breastfeeding by HIV-infected mothers, and the unanticipated hazards of formula feeding, demand a deeper assessment of the measures necessary for optimum policies on infant and child nutrition and for the amelioration of poverty. Piecemeal interventions that increase resources directed at only a fraction of a family's impoverishment, such as basic materials for preparation of hygienic formula feeds and making flawed decisions on choice of infant feeding, are bound to fail. These are not alternatives to taking fundamental steps to alleviate poverty. The economic opportunity costs of such programmes, the equity costs of providing resources to some and not others, and the leakages due to temptation to sell capital goods require careful evaluation. Providing formula to poor populations with high HIV prevalence cannot be justified by the evidence, by humanitarian considerations, by respect for local traditions or by economic outcomes. Exclusive breastfeeding, which is threatened by the HIV epidemic, remains an unfailing anchor of child survival (author's)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | MOTHERS | INFANT | WHO | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | POVERTY | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | SOCIOECONOMIC FACTORS | CHILD SURVIVAL | HIV Infections | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | UN | International Agencies | Organizations | Political Factors | Disease Transmission Control | Prevention and Control | Economic Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Survivorship | Length of Life | Mortality | Population Dynamics
Document Number: 325099

Title: A review of psychometric properties of feeding assessment tools used in neonates.
Author: Howe TH; Lin KC; Fu CP; Su CT; Hsieh CL
Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2008 May-Jun;37(3):338-349.
Abstract: The objective of this study was to appraise the psychometric properties of clinical feeding assessment tools used in a neonatal population. PubMed, OvidMedline, CINHAL, and PsycINFO databases from 1980 to 2007 were searched. Reference lists of all identified articles were also reviewed. Research reports written in English that utilized or validated clinical feeding assessment tools were selected. In total, 941 articles were reviewed. Seven neonatal clinical feeding assessment tools were identified and categorized into three groups: tools used for assessing either bottle-feeding or breastfeeding behaviors, tools used only for assessing bottle-feeding behaviors, and tools used only for assessing breastfeeding behaviors. The psychometric properties of none of the seven assessment tools identified were satisfactory, and the limited representativeness of the samples of the psychometric research was noted in all assessment tools identified. The Neonatal Oral-Motor Assessment Scale appeared to have been examined more thoroughly and showed more consistent results in psychometric properties than the others, despite its own limitations. A psychometrically sound neonate feeding assessment tool has not yet been empirically validated. Clinicians who use these tools for clinical and research purposes should take into account this lack of evidence of psychometric soundness and interpret results of assessment with precautions. Well-designed research is needed to study the scientific integrity of these instruments for program evaluations in neonatal care. (author's)
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | METHODOLOGICAL STUDIES | INFANT NUTRITION | BREASTFEEDING | BOTTLE FEEDING | MEASUREMENT | DATA COLLECTION | RELIABILITY | VALIDITY | Nutrition | Health | Research Methodology
Document Number: 326912

Peer Reviewed

Title: 18-month effectiveness of short-course antiretroviral regimens combined with alternatives to breastfeeding to prevent HIV mother-to-child transmission.
Author: Leroy V; Ekouevi DK; Becquet R; Viho I; Dequae-Merchadou L
Source: PLoS One. 2008 Feb;3(2):e1645.
Abstract: We assessed the 18-month effectiveness of short-course (sc) antiretroviral peripartum regimens combined with alternatives to prolonged breastfeeding to prevent mother-to-child transmission (MTCT) of HIV-1 in Abidjan, Cote d'Ivoire. HIV-1 infected pregnant women received from greater than or less than 32-36 weeks of gestation scZidovudine (ZDV)+/-Lamivudine (3TC)+single-dose Nevirapine (sdNVP) at delivery within the ANRS 1201/1202 DITRAME-Plus cohort (2001-2003). Neonates received a sdNVP+7-day ZDV prophylaxis. Two infant-feeding interventions were systematically offered free of charge: formula-feeding or exclusive shortened breastfeeding with early cessation from four months. The reference group was the ANRS 049a DITRAME cohort (1994-2000) exposed to scZDV from 36 weeks, then to prolonged breastfeeding. Pediatric HIV infection was defined by a positive plasma HIV-1 RNA at any age, or if aged $18 months, a positive HIV-1 serology. Turnbull estimates of cumulative transmission risks (CTR) and effectiveness (HIV-free survival) were compared by exposure group using a Cox model. Among 926 live-born children enrolled, 107 (11.6%) were HIV-infected at 18 months. CTRs were 22.3% (95% confidence interval[CI]:16-30%) in the 238 ZDV long-term breastfed reference group, 15.9% (CI:10-27%) in the 169 ZDV+sdNVP shortened breastfed group; 9.4% (CI:6-14%) in the 195 ZDV+sdNVP formula-fed group; 6.8% (CI:4-11%) in the 198 ZDV+3TC+sdNVP shortened breastfed group, and 5.6% (CI:2-10%) in the 126 ZDV+3TC+sdNVP formula-fed group. Each combination had a significantly higher effectiveness than the ZDV long-term breastfed group except for ZDV+sdNVP shortened breastfed children, ranging from 51% (CI:20-70%) for ZDV+sdNVP formula fed children to 63% (CI:40-80%) for ZDV+3TC+NVPsd shortened breastfed children, after adjustment for maternal eligibility for antiretroviral therapy (ART), home delivery and low birth-weight. Substantial MTCT risk reductions are reachable in Africa, even in short-term breastfed children. The two sc antiretroviral combinations associated to any of the two infant feeding interventions, formula-feeding and shortened breastfeeding, reduce significantly MTCT with long-term benefit until age 18 months and without increasing mortality. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | MOTHERS | PERSONS LIVING WITH HIV/AIDS | INFANT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | ADMINISTRATION AND DOSAGE | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Disease Transmission Control | Prevention and Control | HIV | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Breastfeeding | Infant Nutrition | Nutrition
Document Number: 324887

8.
Peer Reviewed

Title: Infant-feeding practices among HIV-infected mothers in an HIV-treatment programme.
Author: Sadoh WE; Sadoh AE; Adeniran KA; Abhulimhen-Iyoha BI
Source: Journal of Health, Population, and Nutrition. 2008 Dec;26(4):463-7.
Abstract: The transmission of HIV via breastmilk has led to various recommendations for HIV-infected mothers. In this study, the feeding practices of HIV-infected mothers in the first six months of their infants' lives were evaluated. In total, 103 consecutive mothers of children, aged 6-24 months, were evaluated for their feeding practices in the first six months of their infants' lives. The mothers were recruited in two cohorts based on their entry (PMTCT cohort) or non-entry (non-PMTCT cohort) to an HIV MTCT-prevention programme. Information obtained included maternal age, socioeconomic class, and the educational level attained. All the babies in the non-PMTCT cohort were breastfed compared to none in the PMTCT cohort. Infant formula was inadequately prepared for 77.42% of babies in the non-PMTCT cohort compared to 18.64% in the PMTCT cohort. The mixed-feeding rate was high (70.45%) in the non-PMTCT cohort. Over 70% of babies in both the cohorts were bottle-fed. Voluntary counselling and testing services in the healthcare system should be strengthened. All mothers should receive infant-feeding counselling, with exclusive breastfeeding being encouraged in those with unknown HIV status.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | EVALUATION | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | BREASTFEEDING | COUNSELING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | BOTTLE FEEDING | SUPPLEMENTARY FEEDING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Infant Nutrition | Nutrition | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control
Document Number: 330581

10.

Title: Growth and metabolism of infants born to women infected with human immunodeficiency virus and fed acidified whey-adapted starter formulas.
Author: Velaphi SC; Cooper PA; Bolton KD; Mokhachane M; Mphahlele RM
Source: Nutrition. 2008 Mar;24(3):203-211.
Abstract: The objective was to compare the effects of a biologically and chemically acidified formula with or without probiotics with a standard formula on growth of infants negative for human immunodeficiency virus (HIV). This was a double-masked, randomized, clinical trial. Infants born to consenting HIV-positive women who had decided not to breast-feed before being approached for participating in the study were randomized to receive one of four milk formulas: a chemically acidified formula with or without probiotics (Bifidobacterium lactis), a biologically acidified formula, or a standard whey formula. Infants who subsequently became HIV-positive according to polymerase chain reaction at 6 wk were excluded. Their growth and biochemical status were monitored for 4-6 mo. The z scores at the last visit of infants in each of the four formula groups were compared using analysis of covariance correcting for the z scores at baseline. Blood gases and pH were analyzed using a two-way analysis of variance corrected for center. One hundred thirty-two HIV-negative infants were monitored for growth and biochemical parameters for 4-6 mo. There was an improvement of z scores for all formulas, and there were no differences in weight for age (P = 0.22), length for age (P = 0.56), head circumference for age (P = 0.66), or weight for length (P = 0.13). There were no differences in blood pH and biochemical parameters among the formula groups. The growth of infants fed one of the three acidified formulas was not inferior to the standard formula. Growth and metabolism in HIV-negative infants fed the acidified formulas were not affected by the method of milk acidification. (author's)
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | INFANT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | BOTTLE FEEDING | MILK SUBSTITUTES | GROWTH | BODY WEIGHT | INFANT NUTRITION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Nutrition | Health | Child Development | Biology | Physiology
Document Number: 324340

11.

Peer Reviewed

Title: Bacterial contamination and over-dilution of commercial infant formula prepared by HIV-infected mothers in a prevention of mother-to-child transmission (PMTCT) programme, South Africa.
Author: Andresen E; Rollins NC; Sturm AW; Conana N; Greiner T
Source: Journal of Tropical Pediatrics. 2007 Dec;53(6):409-414.
Abstract: To examine the safety of formula feeds used by mothers participating in a Prevention of Mother-to-Child Transmission (PMTCT) programme, contents of 94 feeding bottles collected at a PMTCT-clinic were analysed. An additional 17 samples were taken from already prepared feeds during home visits, as well as 21 samples from bottles prepared under observation. Living conditions and educational levels were overall good and mothers had been counselled on safe formula preparation. Samples were analysed for faecal bacteria, using Escherichia coli and Enterococcus sp. as indicators. Protein concentration was used as an indicator of concentration of the formula. Out of 94, 63 (67%) of samples obtained at the clinic and 13/16 (81%) of available home samples were contaminated with faecal bacteria, compared to 8/21 (38%) of those prepared under observation. Out of 94, 58 (62%) of the clinic samples containing E. coli and 23/94 (24%) of those containing Enterococcus sp. were contaminated with more than the US government recommended limit of 10 CFU/ml. Out of 94, 26 (28%) of samples obtained at the clinic, 8/17 (47%) of home samples and 3/21 (14%) of those prepared under observation were over-diluted, compared to standards. Many mothers did not follow recommended practices in preparing and feeding the bottles. (author's)
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SAFETY | MOTHERS | PERSONS LIVING WITH HIV/AIDS | BOTTLE FEEDING | WATER QUALITY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | COUNSELING | MORBIDITY | INFANT MORTALITY | HYGIENE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Public Health | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infant Nutrition | Nutrition | Water | Natural Resources | Environment | Disease Transmission Control | Prevention and Control | Clinic Activities | Program Activities | Programs | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 314025

12.

Peer Reviewed

Title: Awareness about feeding options for infants born to HIV positive mothers and mother to child transmission of HIV in Gurage zone, south Ethiopia.
Author: Belachew T; Jira C
Source: Ethiopian Journal of Health Development. 2007;21(1):40-47.
Abstract: Strategies to respond to the global HIV epidemic include preventing new infections and providing care and support to infected individuals. Prevention of Mother to Child Transmission of HIV (PMTCT) is one of the strategies given high priority. The objective was to assess awareness of prevention of mother to child transmission of HIV. A cross-sectional community based study was conducted in Gurage zone in October 13-28, 2004. A total of 657 participants were involved in the study. Data were collected by 12 grade completed trained enumerators using structured interviewer administered questionnaire. Overall, 84% of the respondents were aware of the recommended feeding options for infants below six months born to HIV positive women. Subjects who had good knowledge about HIV/AIDS, and those residing in the urban areas were more likely to mention the recommended feeding options, OR (95%CI) = 2.53(1.40, 4.56) and (95%CI) = 1.83(1.13, 2.96), respectively. Only 24% mentioned that mother-to-child transmission occurs via breast milk. Respondents with good knowledge on HIV/AIDS were twice likely to know the usefulness of VCT during pregnancy in preventing MTCT, OR (95%CI) = 1.84(1.09, 3.09). Awareness of the community about the risk of MTCT of HIV via breast milk was low. Urban residents and those who had good knowledge on HIV/AIDS were more likely to have correct knowledge on the feeding option for infants born to HIV positive mothers. (author's)
Language: English
Keywords:
ETHIOPIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | QUESTIONNAIRES | INFANT | PERSONS LIVING WITH HIV/AIDS | MOTHERS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | BOTTLE FEEDING | BREASTFEEDING | FOOD SUPPLEMENTATION | KNOWLEDGE | AWARENESS | COUNSELING | EVALUATION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Infant Nutrition | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 323362

13.

Title: Breastfeeding and HIV transmission. Authors' reply [letter]
Author: Coovadia HM; Rollins NC; Bland RM; Coutsoudis A; Newell ML
Source: Lancet. 2007 Jun 23;369(9579):2073-2074.
Abstract: In their Comment on the paper by Hoosen Coovadia and colleagues, Wendy Holmes and Felicity Savage expose their personal biases by warmly embracing the paper's findings, and fail to contextualise its importance. The paper describes the risks of mixed feeding (both formula and breast feeding) compared with exclusive breast feeding in infants of HIV-positive women. Coovadia and colleagues note "that mortality in the first 3 months of life was roughly doubled in the group receiving formula feeding compared with the exclusive breast feeding group (15% vs 6%)" and cautiously describe this as a "concern", without offering any explanation. They do, however, acknowledge an obvious selection bias in that mothers who chose to formula feed were significantly more likely (p<0.0003) to have CD4-cell counts of less than 200 per microL than were mothers who exclusively breastfed. Holmes and Savage fail to recognise or choose to ignore this major bias and instead highlight the finding as "important" in adding to the "accumulation of new evidence on the hazards of formula feeding". They support this assertion by, oddly, referencing a Botswanian study that found breastfeeding plus zidovudine prophylaxis was not as effective as formula feeding in preventing postnatal HIV transmission, and was associated with a similar mortality rate, at 18 months. A more balanced Comment could have discussed the limitations of comparing mortality outcomes at 6 months (as opposed to, say, 2 or 5 years, when the full effect of HIV-infection-related deaths secondary to breastfeeding would be overt), the feasibility of supporting exclusive breastfeeding in nonresearch settings, and the paper's relevance to the development of infant feeding policies for urban HIV-positive parents who might prefer formula feeding, recognising its acceptability, safety, and efficacy in diverse urban settings such as Abidjan, Cote d'Ivoire; Soweto, South Africa; and Bangkok, Thailand. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | BREASTFEEDING, EXCLUSIVE | SUPPLEMENTARY FEEDING | BOTTLE FEEDING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | INFANT MORTALITY | ANTIRETROVIRAL THERAPY | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Breastfeeding | Infant Nutrition | Nutrition | Health | Disease Transmission Control | Prevention and Control | Mortality | Population Dynamics | HIV
Document Number: 318059

14.

Peer Reviewed

Title: HIV, infant feeding, and survival: Old wine in new bottles, but brimming with promise.
Author: Coovadia HM; Coutsoudis A
Source: AIDS. 2007 Sep;21(14):1837-1480.
Abstract: A string of new studies, most of which have been presented at international meetings and are as yet unpublished, have resulted in a gathering momentum of interest in HIV and infant feeding. In rich and some middle-income countries, transmission of HIV antenatally, and during labour and delivery, has been substantially reduced by antiretrovirals and other interventions. Postnatal transmission was prevented by advising against breastfeeding; the alternative was replacement feeding with formula milks as these could be safely prepared, were affordable, and were culturally acceptable. The discourse on formula feeding or breastfeeding by HIV-positive mothers in developing countries has been mired in confusion or locked in robust disagreement. WHO/UNICEF/UNAIDS guidelines offered a framework for making choices based on socioeconomic conditions and household capability to prepare formula hygienically. The difficulty in the field was to offer an optimum balance of choices between the two types of milk feeding. Exclusive breastfeeding for 6 months is the recommendation for those choosing breastfeeding. Recent data from ongoing and completed studies in Africa have suggested that the effects of avoidance of breastfeeding or cessation even at 6 months by HIV-positive mothers can be disastrous. This finding repeats what has been and remains the bedrock of public health policy for infants and children well before the HIV epidemic, and recognized through centuries of human experience. The new findings have led to the WHO refining its Guidelines on HIV and Infant Feeding in late 2006. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | INFANT | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | MILK SUBSTITUTES | CHILD SURVIVAL | RISK FACTORS | TIME FACTORS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | DISEASES | DEATH RATE | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | Viral Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Biology | Disease Transmission Control | Prevention and Control
Document Number: 319621

15.

Peer Reviewed

Title: Effectiveness of the WHO / UNICEF guidelines on infant feeding for HIV-positive women: Results from a prospective cohort study in South Africa.
Author: Doherty T; Chopra M; Jackson D; Goga A; Colvin M
Source: AIDS. 2007 Aug 20;21(13):1791-1797.
Abstract: The World Health Organization (WHO) and UNICEF recommend that HIV-positive women should avoid all breastfeeding only if replacement feeding is acceptable, feasible, affordable, sustainable and safe. Little is known about the effectiveness of the implementation of these guidelines in developing country settings. The objective was to identify criteria to guide appropriate infant-feeding choices and to assess the effect of inappropriate choices on infant HIV-free survival. Prospective cohort study of 635 HIV-positive mother-infant pairs across three sites in South Africa to assess mother to child transmission of HIV. Semistructured questionnaires were used during home visits between the antenatal period and 36 weeks after delivery to collect data concerning appropriateness of infant feeding choices based on the WHO/UNICEF recommendations. Three criteria were found to be associated with improved infant HIV-free survival amongst women choosing to formula feed: piped water; electricity, gas or paraffin for fuel; and disclosing HIV status. Using these criteria as a measure of appropriateness of choice: 95 of 311 women who met the criteria (30.5%) chose to breastfeed and 195 of 289 women who did not meet the criteria (67.4%) chose to formula feed. Infants of women who chose to formula feed without fulfilling these three criteria had the highest risk of HIV transmission/death (hazard ratio, 3.63; 95%confidence interval, 1.48-8.89). Within operational settings, the WHO/UNICEF guidelines were not being implemented effectively, leading to inappropriate infant-feeding choices and consequent lower infant HIV-free survival. Counselling of mothers should include an assessment of individual and environmental criteria to support appropriate infant-feeding choices. (author's)
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | PROSPECTIVE STUDIES | QUESTIONNAIRES | COHORT ANALYSIS | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | MOTHER-TO-CHILD TRANSMISSION | BREASTFEEDING | BOTTLE FEEDING | INFANT HEALTH | INFANT NUTRITION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Transmission | Infections | Nutrition | Health | Child Health
Document Number: 313806

16.

Title: HIV and infant feeding: summary of findings from the Good Start Study.
Author: Doherty T; Chopra M; Jackson D; Colvin M; Goga A
Source: [Durban], South Africa, Health Systems Trust, 2007 Jun. 2 p. (Policy Brief)
Abstract: The Good Start Study was a prospective cohort study of 665 HIV positive women who attended routine PMTCT services. The women and infants were followed for 36 weeks after birth with data collection during home visits every 2 weeks until 12 weeks and then monthly until 9 months. At each scheduled visit infant feeding practices were recorded through 24 hour and previous 3 day recall. The study was undertaken in three sites; Paarl (Western Cape), Umzimkulu (Eastern Cape) and Umlazi (KwaZulu-Natal). Sites were selected to highlight differences in socio-economic regions, health infra-structure, rural-urban locations, and HIV prevalence. The quality of infant feeding counselling is poor with inadequate information provided for women to make appropriate choices. Several gaps were found in the content of PMTCT and infant feeding counseling during pregnancy. Counsellors lacked confidence to take mothers through a logical process of assessing home circumstances, presenting risks and helping them to make a suitable infant feeding choice. Mothers knowledge about infant feeding remained poor after the counseling session. Half were planning to practice sub-optimal feeding uncertainty associated with HIV transmission. However, family members have a strong influence on actual feeding practices in the home. Thus, poor quality counseling, low levels of disclosure, lack of involving key family members in supporting feeding decisions, low levels of self efficacy and limited, if any, postpartum support from the health services lead women to doubt their ability to carry out infant feeding recommendations, thus reducing adherence to their chosen method. (excerpt)
Language: English
Keywords:
SOUTH AFRICA | TECHNICAL REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | INFANT | WOMEN | POSTPARTUM | BOTTLE FEEDING | MATERNAL-CHILD HEALTH SERVICES | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | CHILD SURVIVAL | BREASTFEEDING, EXCLUSIVE | COUNSELING | RECOMMENDATIONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Infant Nutrition | Nutrition | Health | Primary Health Care | Health Services | Delivery of Health Care | Disease Transmission Control | Prevention and Control | Survivorship | Length of Life | Mortality | Population Dynamics | Breastfeeding | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 320947

17.

Title: Growth of infants in relation to type of feeding in Jahrom, Islamic Republic of Iran.
Author: Emamghorashi F; Heydari ST
Source: Eastern Mediterranean Health Journal. 2007;13(4):846-854.
Abstract: We evaluated the growth of 597 infants less than 24 months attending health centers in Jahrom according to type of infant feeding. We also compared our growth curves with those of the National Center for Health Statistics (NCHS). The infants were divided to 3 groups: exclusively breastfed, exclusively bottle-fed and both breast- and bottle-fed and were assessed monthly for the first year and every 2 months in the second year. There were no significant differences between the groups in height and weight in the first few months of birth; later, breastfed infants were significantly heavier and taller. The mean heights and weights of our infants were lower that those for NCHS. (author's)
Language: English
Keywords:
IRAN | RESEARCH REPORT | EVALUATION | INFANT | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | INFANT NUTRITION | BODY WEIGHT | BODY HEIGHT | GROWTH | Developing Countries | Middle East | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Nutrition | Health | Physiology | Biology | Child Development
Document Number: 323868

18.

Title: Breastfeeding and HIV transmission [letter]
Author: Henderson P; Martines J; Mason E
Source: Lancet. 2007 Jan 23;369(9579):2073.
Abstract: We welcome the finding by Hoosen Coovadia and colleagues that exclusive breastfeeding carries a lower risk of HIV transmission than breastfeeding with the addition of other fluids or solids (mixed feeding). WHO and other UN agencies have recommended since 2000 that HIV-infected women who choose to breastfeed should do so exclusively. This recommendation was based on the many benefits to mothers and infants in the general population, while awaiting confirmation of the benefits in relation to HIV transmission suggested by the work of Coutsoudis and colleagues. In October, 2006, WHO hosted a technical consultation to examine new evidence and programmatic experience on HIV and infant feeding since 2000, including information from Coovadia and colleagues' study. A Consensus Statement reflecting these inputs has been available since December, 2006. The main recommendations state that exclusive breastfeeding in the first 6 months of life carries a lower risk of HIV transmission than mixed feeding. HIV-infected women who choose to breastfeed exclusively should do so for 6 months; replacement feeding is recommended only for women for whom it is acceptable, feasible, affordable, sustainable, and safe. The recommendations continue to support the human rights approach that the most appropriate infant feeding option for an HIV-infected mother should depend on her individual circumstances, and that she should be supported in her choice. WHO and partners would welcome wide dissemination of this Consensus Statement. (full text)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | BREASTFEEDING, EXCLUSIVE | SUPPLEMENTARY FEEDING | BOTTLE FEEDING | HIV TRANSMISSION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HUMAN RIGHTS | RECOMMENDATIONS | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Breastfeeding | Infant Nutrition | Nutrition | Health | Disease Transmission Control | Prevention and Control | Political Factors
Document Number: 318057

19.

Title: Media responsibility and child health [letter]
Author: Holla RG; Gupta A
Source: Indian Pediatrics. 2007 Sep 17;44(9):708.
Abstract: One of the most daunting and often frustrating tasks for a pediatrician is convincing a parent to avoid using a bottle for feeding a child. Doctors are taught from their undergraduate days about the propensity of bottle feeding to lead to infection, malnutrition, lactation failure through nipple confusion, dental caries, delayed development of chewing and swallowing, economic deprivation, and problems in young infant and toddlers. To enhance breastfeeding practices, the World Health Organization discourages pacifiers and bottle-feeding. Indeed, the UNICEF/WHO Baby Friendly Hospital Initiative specifically proscribes two such exposures, pacifier use and bottle-feeding, citing their avoidance as important to the successful establishment of breastfeeding. Cup feeding has been recommended by the Baby Friendly Hospital Initiative, and the International Infant Food Action Network as a method for supplementing breastfed infants who require supplemental feedings. Unfortunately, this message has not been percolated adequately and effectively to the public. It is said that a picture speaks a thousand words. The attractive imagery of advertising campaigns by manufacturers of artificial foods and bottles often wins over the pediatrician's pleas. On occasions a seemingly innocent looking picture may influence a large sub set of population in the negative sense, the President's picture of display of affection by bottle-feeding a child being a classical example of the same. The media has, on several occasions done a yeoman task by focusing public attention on burning issues plaguing the country. With their cooperation, it is possible to take important health messages to the community. It is also pertinent to note that the media would be well devised to screen out images that legitimize practices harmful to child health. (full text)
Language: English
Keywords:
INDIA | CRITIQUE | CHILD | BREASTFEEDING | BOTTLE FEEDING | MASS MEDIA | IMPACT | CHILD HEALTH | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Communication
Document Number: 322839

20.

Title: [Breast-feeding, bottle-feeding, sucking habits and malocclusion in Brazilian preschool children] Aleitamento natural, aleitamento artificial, habitos de succao emaloclusoes em pre-escolares Brasileiros.
Author: Leite-Cavalcanti A; Medeiros-Bezerra PK; Moura C
Source: Revista de Salud P�blica. 2007 Apr-Jun;9(2):194-204.
Abstract: Objective: This study was aimed at verifying the prevalence of nutritive (breast-feeding and bottle-feeding) and non-nutritive sucking habits and the presence of malocclusion in Brazilian preschool children. Material and Methods: The study was a cross-sectional oral health survey of 342 children (196 boys and 146 girls) between the ages of 3 and 5 in Campina Grande, Brazil. The data was collected by interviews with the children's mothers or minders and by clinical examinations carried out by a calibrated examiner (kappa = 0.86). Descriptive statistics using the EPI-INFO Program (version 3.3) and Chi-square test at 0.05 probability level were produced. Results: Sucking habit prevalence was very high in all groups. ranging from 70 % to 77.4 %. Malocclusion was present in 87%, dummy use in 84.8% and finger-sucking in 7.2%. About 84.2 % of the children had a history of bottle-feeding and 79.9% showed some evidence of malocclusion at the time of dental examination. There were significant differences for the following variables: sucking habits and malocclusion; breast-feeding time and sucking habits; breast-feeding time and malocclusion; type of feeding and sucking habits; and type of feeding and malocclusion. Conclusion: Dummy-sucking incidence was higher than that of finger-sucking in Brazilian children. Sucking habit incidence was higher in bottle-fed children than in breast-fed children. The relationship between incidence of habits and malocclusion was statistically significant.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | CHILDREN | BREASTFEEDING | BOTTLE FEEDING | BEHAVIOR | INFANT NUTRITION | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Measurement | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health
Document Number: 324813

21.
Peer Reviewed

Title: Acceptability of formula-feeding to prevent HIV postnatal transmission, Abidjan, Cote d'Ivoire: ANRS 1201 / 1202 Ditrame Plus Study.
Author: Leroy V; Sakarovitch C; Viho I; Becquet R; Ekouevi DK
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Jan;44(1):77-86.
Abstract: The objective was to describe the maternal acceptability of formula feeding proposed to reduce postnatal HIV transmission in Abidjan, Cote d'Ivoire. Each consenting HIV-infected pregnant women, age $18 years, who received a perinatal antiretroviral prophylaxis was eligible. Two hierarchical infant-feeding options were proposed antenatally: exclusive formula-feeding or short-term exclusive breast-feeding. Formula-feeding was provided free up to age 9 months. Determinants of acceptability were analyzed using a logistic regression. Formula feeding failure was defined as having breast-fed one's child at least once. Between March 2001 and March 2003, 580 women delivered: 97% expressed their infant-feeding choice before delivery; 53% chose formula-feeding. Significant prenatal determinants for refusing formula-feeding were: living with her partner, being Muslim, having a low educational level, being followed in one of the study sites, having not disclosed her HIV status, and having been included within the first 6 months of the project. Among the 295 mothers who formula-fed, the Kaplan-Meier probability of success of the formula feeding option was 93.6% at Day 2 (95% confidence interval [CI]: 90.7% to 96.3%) and 84.2% at 12 months (95% CI: 79.9% to 88.5%): 46 of 295 (15.6%) women breast-fed at least once, of whom 41% temporarily practiced mixed-feeding at Day 2 because of social stigma or newborn poor health. In settings with general access to clean water, structured antenatal counseling, and sustained provision of free formula, slightly over half of HIV-infected women chose to artificially feed their newborn infant. Low mixed-feeding rates were observed. This social acceptability must be balanced with mother-child long-term health outcomes to guide safe recommendations on infant-feeding among HIV-infected women in African urban settings. (author's)
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | PROSPECTIVE STUDIES | MOTHERS | PERSONS LIVING WITH HIV/AIDS | BOTTLE FEEDING | MOTHER-TO-CHILD TRANSMISSION | PSYCHOSOCIAL FACTORS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infant Nutrition | Nutrition | Health | Transmission | Infections | Behavior
Document Number: 310461

22.

Title: Difficult choices: Infant feeding experiences of HIV-positive mothers in northern Tanzania.
Author: Leshabari SC; Blystad A; Moland KM
Source: SAHARA J: Journal of Social Aspects of HIV / AIDS. 2007;4(1):[12] p.
Abstract: Infant feeding represents a great challenge in the prevention of mother-to-child transmission of HIV (pMTCT). The international guidelines informing infant feeding counseling suggest feeding methods that reduce the risk of HIV transmission, and discourage mixed feeding (combining breastfeeding with other fluids and solids).The feasibility and the social acceptability of the recommended feeding methods are hotly debated currently. Through the documentation of HIV-positive women's experiences, this article aims to provide empirically grounded knowledge on the relevance of the proposed feeding methods. Drawing upon cultural theory and a view of infant feeding practices as socially and culturally embedded, the article discusses the so-called 'informed choice' of infant feeding method among women enrolled in the pMTCT programme at Kilimanjaro Christian Medical Centre in northern Tanzania. The study is based on interviews and follow-up of 20 HIV-positive mothers during the last part of pregnancy, delivery and the first six months after birth. The article details four of these cases describing the challenges linked to exclusive breastfeeding, cow's milk feeding and formula feeding. The study demonstrates the gap between intentions and infant feeding practice in a context where the social expectations to breastfeed are high, and where kin and neighbours are part of the decision-making team surrounding infant feeding. It highlights the tension between the competing concerns of the medical and social risks involved in the choice of infant feeding method, and documents that the feeding options may be difficult to adhere to, whether a mother chooses exclusive breastfeeding or replacement feeding. (author's)
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | FOLLOW-UP STUDIES | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | FRIENDS AND RELATIVES | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | SOCIOCULTURAL FACTORS | INFORMED CHOICE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Breastfeeding | Infant Nutrition | Nutrition | Health | Disease Transmission Control | Prevention and Control | Contraceptive Usage | Contraception | Family Planning
Document Number: 321092

23.

Title: Impact of bottle feeding prohibition on exclusively breastfeeding.
Author: Limpvanuspong B; Patrachai S; Suthutvoravut S; O-Prasertsawat P
Source: Journal of the Medical Association of Thailand. 2007 Oct;90(10):1977-1980.
Abstract: The objective was to compare the time of colostrum expression and quantity of breast milk between early postpartum women who practiced exclusively breastfeeding and who had combined breast and bottle feeding. Seventy mothers who delivered term normal, singleton infants were voluntarily recruited during immediate postpartum period and allocated into two groups. Study group was 35 mothers who practiced exclusively breastfeeding and 35 mothers who practiced combined breast and bottle feeding were control group. Expression of colostrum at 12, 24, and 48 hours and quantity of breast milk at 48 hours after delivery were evaluated and compared between two groups. At 12 and 24 hours after delivery, 65.7% and 88.6% of study group had colostrum compared to 37.1% and 68.6% in control group, respectively. The difference was significantly higher in study group. However, at 48 hours after delivery, there was no statistical difference in both groups. Quantity of breast milk at 48 hours after delivery was 5 mL (2, 10) in the study group compared to 2 mL (0,8) in the control group, which was significantly different. Exclusively breastfeeding since immediate postpartum significantly promote earlier expression of colostrum and higher quantity of breast milk. (author's)
Language: English
Keywords:
THAILAND | RESEARCH REPORT | COMPARATIVE STUDIES | CONTROL GROUPS | MOTHERS | CHILDBIRTH | POSTPARTUM | BOTTLE FEEDING | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | HUMAN MILK | EVALUATION | Asia, Southeastern | Asia | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Puerperium | Infant Nutrition | Nutrition | Health | Breastfeeding | Population Dynamics | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology
Document Number: 321955

24.

Title: Knowledge attitude and practices of mothers regarding breast feeding: A hospital based study.
Author: Malla KK; Malla T; Manandhar DS
Source: Journal of Nepal Paediatric Society. 2007 Jan-Jun;26(1):9-15.
Abstract: The objective was to assess the knowledge and actual practices of mothers regarding breastfeeding and to give advice to them on appropriate way of breastfeeding. Cross sectional prospective study from Poush 1st (Dec 2001)-Ashwin 1st 2059 (Sep 2002).175 mothers of under 1 year old children attending OPD, Well baby clinics and mothers in postnatal ward of KMCTH were interviewed using pre-designed questionnaire. At the end of the interview the mothers were given information on accurate way of breastfeeding. All mothers knew that they had to breast feed their babies, but they did not have adequate knowledge about the appropriate way of breastfeeding. 14.9% knew that they have to initiate breast feed within 1/2 hour of birth, 5.7%had idea on prelacteal feed, 3.4% had idea on importance of colostrums 6.3% knew the meaning of exclusive breast feeding, and none of the mothers had idea on importance on night feeding, Only 26 (14.9%) mothers knew the benefits of breastfeeding completely one side at a time. 57%mothers knew they have to continue breast feeding till 2 years, few mothers were willing to breast feed their male babies even for 3 years, very few mothers (4.5%) knew that expressed breast milk could be used for their babies, 56% had idea on dangers of bottle feed and 32.6% had idea regarding starting complementary feed at 6 month of age. Coming to the practice it was seen that 10.3% mothers initiated breast feeding within 1/2 hour of birth, only 6.9%mothers gave prelacteal feed, Colostrum was fed by 98.8%, 48.6% were practicing exclusive breast feeding, 93% mothers were practicing night feeds, 14.9%mothers practiced feeding one side at a time, 64% mothers were practicing inappropriate attachment and positioning, mothers with higher education back ground were using more bottle feed and was least among the farmer and sweeper mothers, among the use of artificial feed use of lactogen milk was highest (66%), none of the mothers got any advice regarding breast feeding during ANC visits, 44% mothers thought the interview was useful and 56%thought it was very useful. The maternal knowledge towards breast feeding was inadequate and there was a big gap between actual and desired practices. (author's)
Language: English
Keywords:
NEPAL | RESEARCH REPORT | PROSPECTIVE STUDIES | MOTHERS | BREASTFEEDING | KNOWLEDGE | ATTITUDES | EDUCATIONAL STATUS | OCCUPATIONAL STATUS | BOTTLE FEEDING | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Psychological Factors | Behavior | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Employment Status
Document Number: 324072

25.

Title: Is exclusive artificial feeding feasible at 6 months post partum in Cameroon urban areas for HIV-exposed infants? [letter]
Author: Nlend AN; Penda I; Ekobo CS; Tene G; Tsague L
Source: Journal of Tropical Pediatrics. 2007 Dec;53(6):438-439.
Abstract: The aim of the study was to evaluate the feasibility of infant feeding options of HIV positive mothers in urban areas (especially compliance to artificial feeding choices), before the implementation of the infant feeding interventions and procurement of breastmilk-substitutes. We conducted a survey among seropositive women diagnosed during pregnancy and counselled for infant feeding options. At 6 months post delivery an interview was done. 47 mothers were included. Bromocriptine was prescribed to all the mothers who opted for artificial feeding from birth. After counselling 85% of women opted for exclusive artificial feeding of whom 83% mothers practised this option since birth. For those who opted for replacement feeding. The main given reason for infant feeding choice was related to medical or nurses advices. Overall 36% [CI 95%, 22-50] of the mothers who opted for artificial milk faced difficulties to afford supplies during the 6 months, leading into an early introduction of paps. Clinical mastitis were mentioned by all those mothers who breastfed. Infant feeding choices were related to the level of education (X2 = 24.10, P = 0.002). Artificial feeding under recovery of cost seems feasible in urban areas in Cameroon and can be facilitate by the administration of antilacteal drugs. More adequate support must be provided for the mother who breastfeed in order to prevent and to treat mastitis. Additional training for counselling in HIV and infant feeding options is recommended for health workers. (author's)
Language: English
Keywords:
CAMEROON | RESEARCH REPORT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | INFANT | URBAN AREAS | COUNSELING | BOTTLE FEEDING | MILK SUBSTITUTES | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | INTERVENTIONS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Geographic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | Infant Nutrition | Nutrition | Health | Disease Transmission Control | Prevention and Control
Document Number: 323590

26.

Peer Reviewed

Title: Education for expectant fathers in workplaces in Turkey.
Author: Sahip Y; Turan JM
Source: Journal of Biosocial Science. 2007 Nov;39(6):843-860.
Abstract: Worldwide, there is increasing recognition that if family and reproductive health programmes are to be successful, the involvement of men is essential. As part of the problem, men also have to be seen as part of the solution. The reality is that in many countries, including Turkey, men generally do not accompany their partners to health facilities for family planning, antenatal and postnatal services and are not expected to attend the labour or birth of their child. Workplace programmes are a potential strategy for meeting the reproductive health education needs of men in industrial cities such as Istanbul. This intervention study was developed to test the feasibility and effects of expanding a special programme for expectant fathers to large workplaces in Istanbul, with the aim of improving the health of Turkish families during the pregnancy, birth and newborn periods. The findings indicate that it is possible to train workplace physicians in Istanbul to conduct regular educational programmes forexpectant fathers on reproductive health, and that such programmes may have beneficial effects, especially in the areas of pregnancy nutrition, exclusive breast-feeding, and support behaviours. Considering the difficulty of getting men to attend hospital or clinic-based educational programmes in large urban areas, bringing such training programmes to men at their places of work has the potential to be an important strategy. Given that large workplaces in Turkey already have full-time physicians charged with the duty of health education for employees, this is also a feasible strategy. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | QUALITATIVE RESEARCH | INTERVIEWS | CONTROL GROUPS | WORKPLACE | FATHERS | PREGNANCY | ANTENATAL CARE | HEALTH | PREGNANCY COMPLICATIONS | BEHAVIOR | PARTNER COMMUNICATION | CARE AND SUPPORT | CHILDBIRTH | BOTTLE FEEDING | SUPPLEMENTARY FEEDING | POSTPARTUM | MALE ROLE | PARENTAL INVOLVEMENT | POSTPARTUM PROGRAMS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Data Collection | Employment | Macroeconomic Factors | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Diseases | Interpersonal Relations | Pregnancy Outcomes | Infant Nutrition | Nutrition | Puerperium | Social Behavior | Child Rearing | Family Planning Programs | Family Planning
Document Number: 320858

27.

Title: Index for measuring child feeding practices.
Author: Srivastava N; Sandhu A
Source: Indian Journal of Pediatrics. 2007;74(4):363-368.
Abstract: The present investigation was undertaken with the objective of creating an Infant and Child Feeding Index (ICFI) from a set of complementary feeding (CF) practices and to determine its association with growth of infants and young children (6-23 months). A semi-structured interview schedule was used to collect information for 204 children from one large slum (n=104) and two private pediatric clinics (n=100) of urban Vadodara. Results revealed that about half (50.5%) of the children were stunted Ht for Age Z score (HAZ<-2SD), nearly one-fourth (25.5%) were underweight Wt for Age Z score (WAZ<-2SD), but wasting (WHZ Wt for Ht Z score<-2SD) was low (3%). Significant associations were revealed between almost all positive CF practices and nutritional status of the children as measured by HAZ and WAZ (p<0.01), but not with WHZ. Good associations were revealed between ICFI and HAZ and WAZ, but not with WHZ. On multivariate analysis of factors affecting the HAZ, WAZ and WHZ scores, ICFI was not found to be significant whereas maternal education was the most significant factor, which was also found to be associated significantly with ICFI. It is concluded that the composite index in its present form can reflect the CF practices more holistically than just one or few behaviors studied separately. More research is needed in the direction of constituting a composite index which can then be used for research, monitoring, evaluation and much needed advocacy for complementary feeding. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | NUTRITION SURVEYS | CHILDREN | MOTHERS | CHILD NUTRITION | CHILD DEVELOPMENT | ANTHROPOMETRY | NUTRITION INDEXES | BREASTFEEDING | BOTTLE FEEDING | SUPPLEMENTARY FEEDING | Asia, Southern | Asia | Developing Countries | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Biology | Measurement | Research Methodology | Infant Nutrition
Document Number: 317970

28.

Title: Update: Infant and young child feeding practices in the context of HIV / AIDS in Rwanda.
Author: Thairu L
Source: [Kigali], Rwanda, Program for Appropriate Technology in Health [PATH], 2007 Apr 27. 10 p.
Abstract: The purpose of this document is to provide an update on the "Evaluation des pratiques d'alimentation des nourrissons et des jeunes enfants dans le contexte du VIH/SIDA au Rwanda" , a study on HIV and infant feeding conducted in Rwanda in 2005. The document discusses the results of the Rwanda study in light of more recent research and program findings since that work was carried out. The document is supplemented with the new WHO Guidelines on HIV and Infant Feeding, which were published in October 2006 and are attached in their entirety here. The evaluation is a study commissioned by UNICEF, TRAC and the Nutrition Working Group. In this joint endeavor, TRAC was responsible for involving district authorities and health center staff, and for assisting in coordinating the study. Jumapili Rwahungu and I were recruited by UNICEF as consultants for the study. UNICEF also provided funding, logistical support, and technical and organizational oversight. The Nutrition Working Group reviewed the study protocol that we developed and was responsible for ensuring that the results of the study were included in the country's nutrition policy. (excerpt)
Language: English
Keywords:
RWANDA | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | INFANT | CHILDREN | LOW INCOME POPULATION | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PROGRAM EVALUATION | RISK FACTORS | Developing Countries | Africa, Central |