Factors are not the same for risk of stopping exclusive breast-feeding and introducing different types of liquids and solids in HIV-affected communities in Ghana

AbstractExclusive breast-feeding (EBF) for 6 months supports optimal infant growth, health and development. This paper examined whether maternal HIV status was associated with EBF and other infant feeding practices. Pregnant women were enrolled after HIV counselling, and their babies were followed up for up to 1 year. Data on household socio-economics and demographics, maternal characteristics and infants’ daily diet were available for 482 infants and their mothers (150 HIV-positive (HIV-P), 170 HIV-negative (HIV-N) and 162 HIV-unknown (HIV-U)). Survival analyses estimated median EBF duration and time to introduction of liquids and foods; hazards ratios (HR) used data from 1–365 and 1–183 d, adjusting for covariates. Logistic regression estimated the probability of EBF for 6 months. Being HIV-P was associated with a shorter EBF duration (139 d) compared with HIV-N (163 d) and HIV-U (165 d) (P=0·004). Compared with HIV-N, being HIV-P was associated with about a 40 % higher risk of stopping EBF at any time point (HR 1·39; 95 % CI 1·06, 1·84; P=0·018) and less than half as likely to complete 6 months of EBF (adjusted OR 0·42; 95 % CI 0·22, 0·81; P=0·01). Being HIV-P tended to be or was associated with a higher risk of introducing non-milk liquids (HR 1·34; 95 % CI 0·98, 1·83; P=0·068), animal milks (HR 2·37; 95 % CI 1·32, 4·24; P=0·004) and solids (HR 1·56; 95 % CI 1·10, 2·22; P=0·011) during the first 6 months. Weight-for-age Z-score was associated with EBF and introducing formula. Different factors (ethnicity, food insecurity, HIV testing strategy) were associated with the various feeding behaviours, suggesting that diverse interventions are needed to promote optimal infant feeding.

Download Full-text

Breast-feeding counselling mitigates the negative association of domestic violence on exclusive breast-feeding duration in rural Bangladesh. The MINIMat randomized trial

Public Health Nutrition ◽

10.1017/s1368980017001136 ◽

2017 ◽

Vol 20 (15) ◽

pp. 2810-2818 ◽

Cited By ~ 3

Author(s):

Amy L Frith ◽

Shirin Ziaei ◽

Ruchira Tabassum Naved ◽

Ashraful Islam Khan ◽

Iqbal Kabir ◽

...

Keyword(s):

Domestic Violence ◽

Sexual Violence ◽

Infant Feeding ◽

Breast Feeding ◽

Health Messages ◽

Feeding Practice ◽

Cox Regression Analysis ◽

Exclusive Breast Feeding ◽

Controlling Behaviour ◽

Group Experience

AbstractObjectiveTo determine if exclusive breast-feeding counselling modifies the association of experience of any lifetime or specific forms of domestic violence (DV) on duration of exclusive breast-feeding (EBF).DesignIn the MINIMat trial pregnant women were randomized to receive either usual health messages (UHM) or usual health messages with breast-feeding counselling (BFC) in eight visits. During pregnancy (30 weeks), lifetime experience of any or specific forms of DV was measured. Infant feeding practice information was collected from 0 to 6 months at 15 d intervals.SettingMatlab, Bangladesh.SubjectsPregnant and postpartum women (n 3186) and their infants.ResultsAmong women in the UHM group, those who had experienced any lifetime DV exclusively breast-fed for a shorter duration than women who did not experience any lifetime DV (P=0·02). There was no difference, however, in duration of EBF among women in the BFC group based on their experience of any lifetime DV exposure (P=0·48). Using Cox regression analysis, there was an interaction of exposure to any lifetime DV, sexual violence and controlling behaviour, and counselling group with duration of breast-feeding at or before 6 months (P-interaction≤0·08). Among the UHM group, experience of any lifetime DV, sexual violence or controlling behaviour was associated with fewer days of EBF (P<0·05). In contrast, among the BFC group, experience of DV was not associated with duration of EBF.ConclusionsThe experience of DV compromises EBF and the support of breast-feeding counselling programmes could assist this vulnerable group towards better infant feeding practices.

Download Full-text

Adoption of safer infant feeding and postpartum sexual practices and their relationship to maternal HIV status and risk of acquiring HIV in Zimbabwe

Tropical Medicine & International Health ◽

10.1111/j.1365-3156.2006.01758.x ◽

2006 ◽

Vol 12 (1) ◽

pp. 97-106 ◽

Cited By ~ 6

Author(s):

N. V. Tavengwa ◽

E. G. Piwoz ◽

P. J. Iliff ◽

L. H. Moulton ◽

C. D. Zunguza ◽

...

Keyword(s):

Infant Feeding ◽

Sexual Practices ◽

Hiv Status ◽

Maternal Hiv

Download Full-text

Maternal perspectives on infant feeding practices in Soweto, South Africa

Public Health Nutrition ◽

10.1017/s1368980020002451 ◽

2020 ◽

pp. 1-13

Author(s):

Stephanie V Wrottesley ◽

Alessandra Prioreschi ◽

Wiedaad Slemming ◽

Emmanuel Cohen ◽

Cindy-Lee Dennis ◽

...

Keyword(s):

South Africa ◽

Infant Feeding ◽

Breast Feeding ◽

Feeding Practices ◽

African Women ◽

Infant Feeding Practices ◽

Eating Behaviours ◽

Group Discussions ◽

Exclusive Breast Feeding ◽

South African Women

Abstract Objective: To (i) describe the infant feeding practices of South African women living in Soweto and (ii) understand from the mothers’ perspective what influences feeding practices. Design: Semi-structured focus group discussions (FGD) and in-depth interviews (IDI) were conducted, and data were analysed using thematic analysis. Setting: Soweto, South Africa. Participants: Nineteen mothers were stratified into three FGD according to their baby’s age as follows: 0–6-month-olds, 7–14-month-olds and 15–24-month-olds. Four mothers from each FGD then attended an IDI. Results: Although mothers understood that breast-feeding was beneficial, they reported short durations of exclusive breast-feeding. The diversity and quality of weaning foods were low, and ‘junk’ food items were commonly given. Infants were fed using bottles or spoons and feeding commonly occurred separately to family meal times. Feeding practices were influenced by mothers’ beliefs that what babies eat is important for their health and that an unwillingness to eat is a sign of ill health. As such, mothers often force-fed their babies. In addition, mothers believed that feeding solid food to babies before 6 months of age was necessary. Family matriarchs were highly influential to mothers’ feeding practices; however, their advice often contradicted that of health professionals. Conclusions: In South Africa, interventions aimed at establishing healthier appetites and eating behaviours in early life should focus on: (i) fostering maternal self-efficacy around exclusive breast-feeding; (ii) challenging mixed feeding practices and encouraging more responsive feeding approaches and (iii) engaging family members to promote supportive household and community structures around infant feeding.

Download Full-text

The Impact of Maternal HIV Status on Infant Feeding Patterns in Nakuru, Kenya

Journal of Human Lactation ◽

10.1177/0890334407310585 ◽

2008 ◽

Vol 24 (1) ◽

pp. 34-41 ◽

Cited By ~ 4

Author(s):

Elizabeth Kamau-Mbuthia ◽

Ibrahim Elmadfa ◽

Rose Mwonya

Keyword(s):

Infant Feeding ◽

Hiv Status ◽

Feeding Patterns ◽

Maternal Hiv ◽

The Impact

Download Full-text

Infant feeding practices in Xinjiang Uygur Autonomous Region, People's Republic of China

Public Health Nutrition ◽

10.1017/s1368980007246750 ◽

2007 ◽

Vol 10 (2) ◽

pp. 198-202 ◽

Cited By ~ 13

Author(s):

Fenglian Xu ◽

Colin Binns ◽

Jing Wu ◽

Re Yihan ◽

Yun Zhao ◽

...

Keyword(s):

Infant Feeding ◽

Breast Feeding ◽

Feeding Practices ◽

Infant Feeding Practices ◽

Feeding Rates ◽

Autonomous Region ◽

Exclusive Breast Feeding ◽

Republic Of China ◽

Factors Associated ◽

Feeding Methods

AbstractAimsTo document infant feeding methods in the first six months of life in Xinjiang Uygur Autonomous Region, People's Republic of China, 2003–2004. Some problems with breast-feeding in the area are explained.MethodsA longitudinal study of infant feeding practices was undertaken. A total of 1219 mothers who delivered babies during 2003 and 2004 were interviewed in five hospitals or institutes, and after discharge were contacted in person or by telephone at approximately monthly intervals to obtain details of infant feeding practices. Multivariate logistic regression analysis was used to explore factors associated with breast-feeding initiation.Results‘Any breast-feeding’ rates at discharge and at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months were 92.2, 91.3, 89.9, 88.8, 87.7, 86.0 and 73.0%, respectively. ‘Exclusive breast-feeding’ rates at discharge and at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months were 66.2, 47.6, 30.1, 25.8, 22.1, 13.0 and 6.2%, respectively. The main problem of breast-feeding in Xinjiang was the early introduction of formula or water. The average duration of ‘exclusive breast-feeding’ was 1.8 months (95% confidence interval (CI) 1.7–2.0), of ‘full breast-feeding’ 2.8 months (95% CI 2.7–2.9) and of ‘any breast-feeding’ 5.3 months (95% CI 5.2–5.4).ConclusionsInfant feeding methods in Xinjiang were documented in this study and the main problems with infant feeding in Xinjiang are discussed. Further studies are needed to identify factors associated with ‘exclusive breast-feeding’ and duration.

Download Full-text

A BIOCULTURAL INVESTIGATION OF THE WEANLING’S DILEMMA IN KATHMANDU, NEPAL: DO UNIVERSAL RECOMMENDATIONS FOR WEANING PRACTICES MAKE SENSE?

Journal of Biosocial Science ◽

10.1017/s0021932001003212 ◽

2001 ◽

Vol 33 (3) ◽

pp. 321-338 ◽

Cited By ~ 18

Author(s):

TINA MOFFAT

Keyword(s):

Breast Milk ◽

Infant Feeding ◽

Breast Feeding ◽

Cultural Beliefs ◽

Feeding Practices ◽

Primary Objective ◽

Infant Feeding Practices ◽

Urban District ◽

Feeding Method ◽

Exclusive Breast Feeding

The primary objective of this report is to use data from a study of infant growth and weaning practices in Kathmandu, Nepal, to investigate universal recommendations about exclusive breast-feeding up to 6 months postpartum. A secondary objective is to demonstrate the complexity of the biocultural nature of infant feeding practices. A sample of 283 children under 5 years of age and their 228 mothers living in a peri-urban district of Kathmandu participated in this study. The children’s height/length and weight were measured three times over 9 months. At each session, a demographic, child health and infant feeding survey was administered; between sessions, in-depth interviews were conducted with mothers regarding infant feeding practices. While a few of the infants under 2 months were receiving non-breast milk foods, at 3 months of age half of the sample had been introduced to non-breast milk foods and by 7 months all infants were eating non-breast milk foods. A comparison of growth indices and velocities between exclusively and partially breast-fed infants from birth to 7 months of age shows no evidence for a difference in nutritional status between the two groups. Although there are cultural rules about breast-feeding that vary by ethnic group, all mothers followed a feeding method that depended on their assessment of whether the child was getting enough breast milk. The conclusion is that exclusive breast-feeding up to 6 months may not be appropriate for all infants. In this sample, breast-feeding duration is not shortened by the early introduction of non-breast milk foods, as the median age of breast-feeding cessation is 36 months. One of the main reasons for severance was the onset of another pregnancy. Investigation of infant feeding practices must be contextualized in the local ecology of the population. While cultural beliefs about breast-feeding are relevant, mothers’ individual assessments of their children’s nutritional needs and demographic events in parents’ lives must also be considered.

Download Full-text

Placental Malaria histological features and the burden of congenital malaria among HIV/ malaria co-infected mothers in Benin City, Edo State

Nigerian Journal of Paediatrics ◽

10.4314/njp.v48i1.3 ◽

2021 ◽

Vol 48 (1) ◽

pp. 12-19

Author(s):

Fidelis E. Eki-udoko ◽

Ayebo Sadoh ◽

Michael O. Ibadin ◽

Augustine I. Omoigberale

Keyword(s):

Peripheral Blood ◽

Placental Malaria ◽

Blood Film ◽

Hiv Positive ◽

Hiv Status ◽

Chronic Type ◽

Hiv Positive Mothers ◽

Maternal Hiv ◽

Congenital Malaria ◽

Hiv Negative

Background: It is well documented that sub-Saharan Africa bears the highest burden of both malaria and HIV. Coinfection with both diseases is also well documented. Malaria parasites infecting the placenta lead to inflammation, intervillous fibrin deposition and infarction. This pathologic effect of malaria on the placental has led to the staging of placental malaria histology. These pathologic features may reflect different levels in the breach of the integrity of the placenta which may predispose to transmission of congenital malaria and possibly HIV. But few if any have examined the association of maternal placental malaria histology stages in HIV positive and negative mothers and the effects of these on their newborns (congenital malaria). Methods: Subjects were 162 newborns of HIV/malaria co-infected mothers and Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy. Results: The placental malaria histology in HIV positive mothers were predominantly the chronic type (51.9%) and past type (54.6%) in HIV negative mothers respectively. Congenital malaria was significantly more in chronic types of placental malaria histology irrespective of maternal HIV status (p=0.017 in subjects and p= 0.000 in controls respectively) Conclusion: Babies born to mothers are at increased risk for congenital malaria if their placental malaria histology is of the chronic type compared to the other types (active and past) irrespective of maternal HIV status. This risk (chronic type) is highest in mothers with HIV; therefore, all babies born to HIV positive mothers should be screened for congenital malaria and managed as appropriate.

Download Full-text

Clinical Outcome and HIV Status of HIV-Exposed Babies on Exclusive Breast Feeding and Nevirapine Prophylaxis

Annals of Health and Health Sciences ◽

10.5958/2322-0422.2016.00011.4 ◽

2016 ◽

Vol 3 (2) ◽

pp. 48

Author(s):

M.J. Nirmala ◽

Rajendra Naidu ◽

N. Hamsa ◽

P.J. Harsha ◽

R. Gowtham ◽

...

Keyword(s):

Clinical Outcome ◽

Breast Feeding ◽

Hiv Status ◽

Exclusive Breast Feeding ◽

Hiv Exposed

Download Full-text

Maternal HIV status and infant feeding practices among Ugandan women

SAHARA-J Journal of Social Aspects of HIV/AIDS ◽

10.1080/17290376.2010.9724952 ◽

2010 ◽

Vol 7 (1) ◽

pp. 24-29 ◽

Cited By ~ 3

Author(s):

Pius Okong ◽

Praxedes Kituuka Namaganda ◽

Luciana Bassani ◽

Mary Mbidde Tabaro ◽

Francesca Zanetto ◽

...

Keyword(s):

Infant Feeding ◽

Feeding Practices ◽

Infant Feeding Practices ◽

Hiv Status ◽

Maternal Hiv

Download Full-text

Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015

BMJ Global Health ◽

10.1136/bmjgh-2020-004398 ◽

2021 ◽

Vol 6 (5) ◽

pp. e004398

Author(s):

Eric Remera ◽

Frédérique Chammartin ◽

Sabin Nsanzimana ◽

Jamie Ian Forrest ◽

Gerald E Smith ◽

...

Keyword(s):

Higher Education ◽

Child Mortality ◽

Scale Up ◽

Mortality Rates ◽

Hiv Treatment ◽

Hiv Status ◽

Multivariable Logistic Regression Model ◽

Live Births ◽

Maternal Hiv ◽

Hiv Negative

IntroductionChild mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda.MethodsWe used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother’s HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother’s HIV status.ResultsIn total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1–2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality.ConclusionsThis study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span.

Download Full-text