Determinants of infant feeding choices by Zambian mothers

A mixed quantitative and qualitative study

Datos Bibliográficos

ID15536129
AutoresMolly Chisenga (0000-0003-0298-2397, University Teaching Hospital, autor de correspondencia), Joshua Siame (University of Zambia), Kathy Baisley (0000-0003-1849-6625, London School of Hygiene & Tropical Medicine), Lackson Kasonka (0000-0001-7525-2382, University Teaching Hospital), Suzanne Filteau (0000-0002-1119-6825, University of London)
Año2010
Volumen7
Número2
Páginas148-159
Fecha de publicación2010-09-07
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaMaternal and Child Nutrition (JOURNAL)
Identificadores de la revistaISSN: 1740-8695 • E-ISSN: 1740-8709
EditorialWiley (PUBLISHER • GB)
DOI10.1111/j.1740-8709.2010.00264.x
PMID21410882
OpenAlexW1482125805
IdiomaEN
Citas recibidas11
Referencias citadas15

Choosing an infant feeding mode is complex for human immunodeficiency virus (HIV)-infected African women. We documented infant feeding choices by 811 mothers of infants aged less than 18 months enrolled in the Chilenje Infant Growth, Nutrition and Infection Study of fortified complementary or replacement foods. We also conducted 20 interviews and 4 focus group discussions among women and nurses to explore the issues in depth. Practices of most HIV-infected women did not closely follow national or international guidelines: 26% never initiated breastfeeding, and 55% were not breastfeeding by 6 months post partum. Women of lower socio-economic status and those not meeting criteria for safe replacement feeding were more likely to initiate breastfeeding, to continue longer and to stop at 6 months when provided with free food within the trial. Most HIV-negative women and women of unknown HIV status continued breastfeeding into the infant's second year, indicating limited 'spillover' of infant feeding messages designed for HIV-infected women into the uninfected population. Qualitative work indicated that the main factors affecting HIV-infected women's infant feeding decisions were the cost of formula, the advice of health workers, influence of relatives, stigma and difficulties with using an exclusive feeding mode. Rapidly changing international recommendations confused both mothers and nurses. Many HIV-infected women chose replacement feeding without meeting criteria to do this safely. Women were influenced by health workers but, for several reasons, found it difficult to follow their advice. The recently revised international HIV and infant feeding recommendations may make the counselling process simpler for health workers and makes following their advice easier for HIV-infected women

Breast feeding · Environmental health · Infant feeding · Qualitative research · Adolescent Sexual and Reproductive Health · Breastfeeding Practices and Influences · HIV/AIDS Research and Interventions · Medicine · Pediatrics