Details:

Alternative Title:
BMC Pediatr
Personal Author:
Okanda, John O ; Borkowf, Craig B ; Girde, Sonali ; Thomas, Timothy K ; Lecher, Shirley Lee
Okanda, John O ; Borkowf, Craig B ; Girde, Sonali ; Thomas, Timothy K ; Lecher, Shirley Lee Less -
Description:
Background

One of the most effective ways to promote the prevention of mother-to-child transmission (PMTCT) of HIV-1 in resource-limited settings is to encourage HIV-positive mothers to practice exclusive breastfeeding (EBF) for the first 6 months post-partum while they receive antiretroviral therapy (ARV). Although EBF reduces mortality in this context, its practice has been low. We studied the rate of adherence to EBF and assessed associated maternal and infant characteristics using data from a phase II PMTCT clinical trial conducted in Western Kenya which included a counseling intervention to encourage EBF by all participants.

Methods

We analyzed data from the Kisumu Breastfeeding Study (KiBS), conducted between July 2003 and February 2009. This study enrolled a total of 522 HIV-1 infected pregnant women. Data on breastfeeding were available for 480 mother-infant pairs. Infant feeding and general nutrition counseling began at 35 weeks gestation and continued throughout the 6 month post-partum intervention period, following World Health Organization (WHO) infant feeding guidelines. Data on infant feeding were collected during routine clinic visits and home visits using food frequency questionnaires and dietary recall methods. Participants were instructed to exclusively breastfeed until initiation of weaning at 5.5 months post-partum. We used Kaplan-Meier methods to estimate the rates of EBF at 5.25 months post-partum, stratified by maternal and infant characteristics measured at enrollment, delivery, and 2 weeks post-partum.

Results

The estimated EBF rate at 5.25 months post-partum was 80.4%. Only 3% of women introduced other foods (most commonly water with or without glucose, cow’s milk, formula, and fruit) by 2 months; this percentage increased to 5% of women by 4 months. Women who had ≥3 previous births (p < 0.01) and who were not living with the infant’s father (p = 0.04) were more likely to exclusively breastfeed. Mixed feeding was more common for male infants than for female infants (p = 0.04).

Conclusion

Exclusive breastfeeding was common in this clinical trial, which emphasized EBF as a best practice until infants reached 5.5 months of age. Counseling initiated prior to delivery and continued during the post-partum period provided a consistent message reinforcing the benefits of EBF. The findings from this study suggest high adherence to EBF in resource limited settings can be achieved by a comprehensive counseling intervention that encourages EBF.


Subjects:
[+]
Adult Antiretroviral Therapy, Highly Active Breast Feeding Counseling Female HIV-1 HIV Infections Humans Infant, Newborn Infectious Disease Transmission, Vertical Male Maternal Age Parity Patient Compliance Perinatal Care Pregnancy Pregnancy Complications, Infectious Socioeconomic Factors Young Adult
Source:
BMC Pediatr. 14
Pubmed ID:
25380718
Pubmed Central ID:
PMC4326202
Document Type:
Journal Article
Place as Subject:
Kenya
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:73c555d65694b13da5437f028b9a14b94723d9519b87db88dbfcf7193f852b21
Download URL:
https://stacks.cdc.gov/view/cdc/27799/cdc_27799_DS1.pdf
File Type:

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