Magister Scientiae (Nutrition Management) - MSc(NM) / The Ministry of Health in Malawi promotes exclusive breastfeeding for the first six months of life and continued breastfeeding with appropriate complementary feeding up to two years or beyond. This policy applies to all children unless there are medical indications. Baby Friendly Hospital Initiative (BFHI) is a strategy that contributes to the attainment of this policy. BFHI is a strategy to increase early and exclusive breast feeding rates among mothers. This study is a pilot to evaluate the success of the BFHI initiative in Malawi.Study design. A cross- sectional cohort study of women and their infants, 0-5 months,attending BFHI and non-BFHI accredited health facilities in Blantyre district of Malawi ] between the period from 28th April to 30th September, 2008 was conducted.Data Collection: An in-depth face-to-face interview using an open-ended structured questionnaire was conducted among 202 mothers of infants within the first week of birth.A convenient sample of 102 mothers was selected from prima gravida mothers at a semiurban BFHI accredited facility while the other 100 were from semi-urban non-BFHI accredited facilities. This sample was used for the descriptive component of the study.From the 202 mothers, 30 from the BFHI and 30 from the non-BFHI Accredited health facility(s) were selected randomly as the sample for the longitudinal cohort of the study at 3 and 5 months respectively.Analysis of results: Data was analyzed using SPSS for Windows. Frequencies were tallied for categorical variables and mean standard deviations were computed for continuous variables. Chi-square p-values with health facility type as classification were computed to determine the difference between BFHI and non-BFHI accredited health facility groups for all relevant variables.Results Exclusive breastfeeding rates differed significantly (p- value, 0.0000) within one week after birth (99% for the BFHI versus 68% for the non-BFHI facilities).Thirty percent of the mothers from the BFHI accredited health facility practiced exclusive breastfeeding up to 5 months as compared to none of the mothers in non-BFHI accredited health facilities.All 202 mothers had ever breast feed in both facilities throughout the 5 months study period.Mothers and mothers-in-law were the significant source of complementing breast milk before 6 months of age,[ 25% more influence of mothers and mothers in-law in the non-BFHI accredited facility when compared to BFHI accredited facility].Conclusion:The BFHI strategy has the potential to successfully influence mothers to adhere to global and national recommendations on optimal breastfeeding practices. Special efforts should be made to continue support of and provide information to new mothers during the first week after delivery and unto few months after birth as mothers seem to introduce complementary foods early and prior to the recommended period of 6 months.

Introduction A group of 317 HIV-1 infected pregnant women and 53 postpartum HIV-negative women were recruited for a two-year prospective descriptive study of psychosocial and other determinants of antenatally planned and actual postnatal feeding, associations between maternal status and infant feeding practices, and health outcomes. Methods The subjects were interviewed periodically for 2 years using structured research instruments. Anthropometric measurements, biomarkers of nutritional status and measurements of pysychosocial wellbeing were obtained from the mothers. Data was collected on infant feeding and outcomes for the babies. Results At recruitment, 74% of mothers planned to formula-feed. Significant differences between these women and those who planned to breastfeed emerged. After delivery, 25% of the women who antenatally planned to formula-feed changed their minds and actually breastfed. Conversely, half of the women who antenatally planned to breastfeed actually formula-fed. Some significant reasons emerged for these feeding changes. Most mothers were well-nourished or overweight. Breastfeeding mothers lost little weight between six weeks and six months after delivery. At the end of follow-up, 65% were obese. While there were differences between HIV-infected and uninfected women in respect of micronutrients, no deficiencies were observed. Vitamin A and selenium concentrations were higher in the HIV-infected women than uninfected women at six weeks. There were no significant micronutrient changes over time. Most mothers maintained an adequate immune status with only slow deterioration of CD4 counts. At two years postpartum, 60% had a CD4 cell count greater than 500cells/mm³, and only about 8% less than 200/mm3. HIV transmission was 15% by 24 months of follow-up. Among the 65 ever breastfed children, 16 (24.6%) were HIV-infected compared to 12.8% of never breastfed children. Most children were growing normally, suggesting that, overall, maternal HIV status did not interfere with feeding ability. Eight mothers (3%) and 33 children (11%) died. Only 12 of 33 children who had died had a positive HIV-PCR. By 2 years, 78% surviving HIV-infected children had been initiated onto ARV therapy. Maternal adherence to HAART was poor. Conclusion HIV and infant feeding counselling is inadequate in the routine PMTCT programme, with stigma and lack of disclosure continuing as major barriers to appropriate care. Whilst maternal obesity was common, most children were growing normally. Weaknesses in routine PMTCT services were identified, and compliance with HAART was poor. / Thesis (PhD)--University of Pretoria, 2010. / Paediatrics and Child Health / unrestricted

To determine the relationship between infant-feeding practices and diarrhoeal infections, a descriptive survey was conducted to infants between six to 12 months of age. A guided interview was conducted to 105 mothers of infants who attended the health facilities of Mbabane, Swaziland. The results show that breast-feeding is routinely practiced by the majority of mothers and exclusive breast-feeding is very low, but supplementary feed in the form of formula or solids are introduced by the majority of respondents within the first three months of life. Infants who were given colostrum and breast milk had fewer diarrhoeal attacks. Other factors, for example education and cultural factors influenced the feeding practices and number of diarrhoeal attacks. It is recommended that breast-feeding should be promoted as an important intervention in the control of diarrhoea / Health Studies / M.A. (Nursing Science)

Introdução: Intervenções educacionais que preparam as equipes de saúde para a promoção e apoio a práticas alimentares saudáveis na infância podem ser efetivas na melhoria dos desfechos relacionados à saúde, nutrição e desenvolvimento infantil. Objetivo: Avaliar se a utilização de um material de educação permanente, elaborado para apoiar o tutor da Estratégia Amamenta e Alimenta Brasil (EAAB), é efetivo em melhorar indicadores de implementação da EAAB e indicadores de alimentação infantil em crianças menores de um ano. Métodos: Estudo de intervenção do tipo antes e depois realizado no município de Embu das Artes, SP. A intervenção consistiu em disponibilizar o Manual como material de apoio às atividades educativas sobre aleitamento materno e alimentação complementar que poderia ser usado por tutores da EAAB. Os tutores realizaram atividades de treinamento com as equipes de saúde durante oito meses. A coleta de dados ocorreu nos momentos pré e pós intervenção e em ambos foram aplicados: teste de conhecimentos sobre aleitamento materno (AM) e alimentação complementar (AC) aos tutores e profissionais de saúde; questionário auto aplicado junto aos gerentes para caracterização das UBS quanto às ações de promoção do AM e AC e entrevistas junto às mães sobre as práticas de alimentação da criança. Análise de dados: a tese gerou 3 manuscritos: No primeiro com o objetivo de avaliar as práticas de alimentação complementar das crianças de 6 a 12 meses utilizou-se análise de regressão de Poisson com modelagem hierarquizada para determinar os fatores associados ao consumo de alimentos ultra processados. O segundo e o terceiro manuscritos avaliaram os efeitos da intervenção. O segundo teve como foco a aplicação do Manual e sua influência na implementação da EAAB, utilizando duas abordagens: na quantitativa foram analisados dimensões e indicadores do processo de implementação com base no modelo lógico da intervenção e na qualitativa foi avaliada a percepção dos tutores acerca do processo de utilização do Manual. O terceiro manuscrito avaliou a efetividade do Manual na melhoria dos indicadores de alimentação infantil e para tanto utilizou-se análise de regressão de Poisson multinível com modelagem hierarquizada. Resultados: Manuscrito 1. A prevalência de consumo de alimentos ultra processados foi de 43,1% entre os menores de um ano. Baixa escolaridade materna e falta de atendimento na primeira semana de vida da criança foram fatores associados ao consumo de alimentos ultra processados. Manuscrito 2. O Manual foi utilizado por 9 dos 13 tutores do município e a intervenção em algum grau foi realizada em 11 de 13 UBS. Em média foram realizadas 3,5 [0-5] atividades complementares por UBS. A média de acertos dos tutores no teste de conhecimentos inicial foi 31,43 ± 5,25 e final 34,86 ± 4,45; p= 0,021. Entre os trabalhadores a média no pré-teste foi 26,09 ± 4,45 e no pós-teste 30,28 ± 3,55; p= 0,002. Em média o número de critérios de certificação alcançados pelas UBS foi maior depois da intervenção (pré 3 [1-6] versus pós 5 [3-6]) e apresentou consistência com a percepção de mudanças dos gerentes assim como com o número de atividades conduzidas pelos tutores. A avaliação da intervenção sob a ótica dos tutores revelou contribuições do uso do Manual para sua atuação. Manuscrito 3. A intervenção foi efetiva para a redução da falta de diversidade alimentar mínima e da falta de adequação alimentar, indicador que avalia a frequência, consistência e diversidade da AC. Porém, não se verificou efeito sobre a interrupção do AME. Conclusões: A investigação das práticas de alimentação infantil na população estudada evidenciou um alto consumo de alimentos ultra processados, reforçando a necessidade de intervenções que promovam práticas alimentares saudáveis na infância. O uso do Manual de Apoio ao Tutor melhorou o conhecimento dos tutores e trabalhadores da atenção básica e promoveu mudanças no processo de trabalho das equipes, refletidas no alcance dos critérios de certificação na EAAB, evidenciando o potencial de uma intervenção educativa usando metodologia crítico-reflexiva. Além disso, a intervenção mostrou-se efetiva para melhorar as práticas de alimentação complementar na população estudada. / Introduction - Educational interventions that prepare healthcare teams to promote infant feeding practices can be effective in improving outcomes related to health, nutrition and child development. Objective - To evaluate whether a continuing education tool (the Manual to Support Estratégia Amamenta e Alimenta Brasil (EAAB) Tutors) can improve EAAB implementation indicators and feeding practices in infants under one year of age. Methods - A before and after study was conducted at 13 primary healthcare units (PHU) in Embu das Artes, São Paulo. The intervention consisted in providing the Manual to support educational activities on breastfeeding and complementary feeding that could be used by tutors of EAAB. Tutors performed comprehensive training activities with healthcare teams over eight months. In both cross-sectional studies (pre and post intervention) a questionnaire was applied to the managers from the 13 PHU to characterize the healthcare service and actions to promote breastfeeding and complementary feeding; knowledge tests were also applied to tutors and health workers indicators of breastfeeding and complementary feeding practices were assessed by interviewing 1,159 mothers. Analysis: the thesis resulted in three manuscripts - The first one aimed to evaluate the complementary feeding practices of children from 6 to 12 months with a focus on the consumption of ultraprocessed foods (UPF) and multiple hierarchical models were performed. The second and third manuscripts evaluated the effects of the intervention. The second evaluated the application of the Manual and its influence on the implementation of EAAB, with two approaches: in the quantitative, the dimensions and indicators of the implementation process were analyzed based on the logical model of the intervention; in the qualitative approach the perception of the tutors about the process of manuals\' use was evaluated. The third manuscript evaluated the effectiveness of the Manual in improving indicators of infant feeding practices. Multivariate analysis was performed using Poisson multilevel regression Results: Manuscript 1: The prevalence of UPF consumption was 43.1% among children. Lower maternal education and lack of early assistance at the PHU were factors associated with higher UPF consumption. Manuscript 2: The Manual was used by 9 of 13 tutors and the intervention was performed in 11 of 13 PHU. In average, 3.5 [0-5] comprehensive training activities (CAs) were performed by PHU. The mean scores of tutors in the initial knowledge test were 31.43 ± 5.25 and final 34.86 ± 4.45; p = 0.021. Among health workers, the mean in the pre-test was 26.09 ± 4.45 and in the post-test 30.28 ± 3.55; p = 0.002. In average, the number of certification criteria fulfilled by the PHS was higher after intervention (before 3 [1-6]; after 5 [3-6]) and was consistent with the changes perceived by managers as well as with the number of CAs carried out by tutors. Tutors\' perception revealed contributions of the Manual for their action. Manuscript 3: The intervention was effective in reducing the lack of minimum food diversity and the lack of food adequacy, an indicator that evaluates the frequency, consistency and diversity of complementary feeding. However, there was no effect on interruption of exclusive breastfeeding. Conclusions: The investigation of infant feeding practices in the study population evidenced a high ultra-processed foods consumption, reinforcing the need of interventions to promote healthy eating practices in childhood. The use of the Manual to Support EAAB Tutors improved the knowledge of tutors and primary healthcare workers and promoted improvements in the work process of healthcare teams, reflected in the achievement of the EAAB certification criteria, evidencing the potential of an educational intervention using problem-based learning methodology. In addition, the intervention proved to be effective in improving complementary feeding practices in the study population.

Introdução: A deficiência de ferro decorre, principalmente, da quantidade insuficiente de ferro na dieta para atender às necessidades nutricionais do indivíduo. Seu estágio mais grave, a anemia ferropriva, é reconhecida como um problema epidemiológico da maior relevância, sendo as crianças em idade pré-escolar, especialmente os lactentes, o grupo mais vulnerável à desnutrição. Objetivo: Identificar a prática alimentar e estimar sua capacidade de atender à recomendação e à necessidade de ferro das crianças de 6 a 23 meses de idade atendidas pela Estratégia Saúde da Família no Maranhão. Métodos: Estudo transversal de base populacional realizado no estado do Maranhão. A partir dos dados de consumo referido (inquérito recordatório de 24h), foram identificadas as práticas alimentares e calculadas quantidades de ferro, vitamina C e de energia a partir dos quais se quantificou o ferro biodisponível utilizando a equação de Monsen e Balintfly. Estimaram-se, ainda, as densidades do ferro total e do ferro biodisponível, além da adequação às recomendações da OMS. Resultados: Do total de 401 crianças estudadas, 7 crianças permaneciam em aleitamento materno exclusivo e dentre aquelas em que foi referida a alimentação complementar, o leite materno esteve presente entre 53 por cento delas, mesmo com a introdução do leite de vaca. A quantidade média de energia foi 826 kcal; ferro total 5,4 mg; ferro biodisponível 0,31 mg; densidade de Ferro/1000kcal= 6,4 e densidade de Ferro biodisponível/1000kcal= 0,34. Em comparação às recomendações, a ingestão energética apresentou valores abaixo da recomendação para mais de 50 por cento da população de estudo, em todas as faixas etárias, já em relação ao ferro, a partir dos 15 meses pelo menos 60 por cento das crianças alcançam a recomendação. Conclusão: A prática alimentar não se mostrou adequada para atender à recomendação e à necessidade de ferro diária, o que pode ser explicado pelo baixo consumo de alimentos fontes de ferro, com boa biodisponibilidade do mineral e de alimentos estimuladores de sua absorção. / Introduction: Iron deficiency is mainly due to the insufficient amount of iron in the diet to meet the nutritional needs of the individual. Its most severe stage, iron deficiency anemia is recognized as an epidemiological problem of the greatest importance, being the children of preschool age, especially infants, the group most vulnerable to malnutrition. Objective: To identify eating habits and estimate their ability to meet the recommendation and the need of iron for children 6-23 months of age served by the Family Health Strategy in Maranhão. Methods: Sectional study population-based study conducted in the state of Maranhão. From the data of consumption above (R24h), dietary practices and calculated amounts of iron, vitamin C and energy were identified from which the bioavailable iron was quantified using the equation of Monsen and Balintfly. Were estimated, furthermore, the densities of total iron and bioavailable iron, as well as compliance with WHO recommendations. Results: Of the 401 children studied, seven children remained in exclusive breastfeeding and among those that was reported complementary feeding, breast milk was present among 53per cent of them, even with the introduction of cow\'s milk. The average amount of energy was 826 kcal; Total Iron 5.4 mg; bioavailable iron 0.31 mg; density of Iron / 1000 kcal = 6.4 and density of bioavailable iron / 1000 kcal = 0.34. Compared to the recommendations, energy intake showed values below the recommendation for more than 50per cent of the study population in all age groups, as compared to iron, from 15 months at least 60per cent of children reach the recommendation. Conclusion: A diet was not adequate to meet the recommendation and the need for daily iron, which can be explained by low consumption of iron-rich foods with good bioavailability of the mineral-stimulating food absorption.

Une étude de la croissance et de l'alimentation de l'enfant en milieu urbain à Dakar (Sénégal) a été réalisée auprès de 1479 enfants de la naissance à l'âge de 36 mois et de leurs mères. Deux zones de niveau socio-économique contrasté dans le milieu urbain ont été sélectionnées : la zone de Médina, au centre de Dakar et la zone de Pikine, aux portes de Dakar. L'enquête s'articule autour du recueil de données anthropométriques chez les couples mère-enfant sélectionnés selon des critères objectifs de « bonne santé » et de la collecte d'un vaste ensemble de données environnementales (socioéconomiques, sociodémographiques, sanitaires et biologiques). L'approche quantitative de la croissance et de l'alimentation de l'enfant s'est effectuée par questionnaire auprès des mères sélectionnées. L'approche qualitative par focus group a permis d'apporter un éclairage plus fin des tendances observées dans l'enquête quantitative. Les données de l'enquête transversale sur la croissance de l'enfant ont été utilisées pour étudier les paramètres staturo-pondéraux des enfants, selon des variations imputables au genre, à l'âge de l'enfant ou à la zone de résidence. Peu de différences sont apparues dans la croissance entre Pikine et Médina. L'état nutritionnel des enfants (définis selon la norme de croissance OMS 2006) se dégrade néanmoins avec l'âge. La malnutrition s'exprime sous des signes différents selon la zone de résidence mais n'est pas plus fréquente dans la zone moins favorisée de Pikine. En revanche, les déterminants de la malnutrition sont communs aux deux zones enquêtées et laisse peu de place aux facteurs socio-économiques. / A population-based study about growth and feeding practices was conducted with a cluster sample of 1479 aged 0 to 36 months and their mother, in the urban area of Dakar (Senegal). In this urban area, two socioeconomic contrasted areas were selected : Medina zone, in the center of Dakar and Pikine zone, located at the city's doorstep. This study is organized around an anthropometric survey of healthy children and their mother and an extensive data collection (socioeconomic, socio-demographic, health and biological data). Questionnaires were addressed to the mothers and belong to the quantitative approach of growth and feeding practices among children. The aim of the qualitative approach by focus groups was to shed light on trends revealed by questionnaires analysis. Cross-sectional data extracted from a growth survey were used to determine the variation in the growth parameters due to sex, child's age or place of residence. Some minor differences could be observed between Pikine and Medina. Nutritional status (assessed by new WHO Growth Standards) decline as children are getting older. Among the two areas, malnutrition exists in different form but it's not area specific since the less-favoured area (Pikine) is not more affected by it. Nonetheless, there are common factors associated with malnutrition, which indicate the low economic impact. Birth-weight and maternal body mass index systematically belongs to the same and most explicative statistics models. The role of feeding practices (apprehended by food consumption) is not that important to explain malnutrition.

<p>Promotion of exclusive breastfeeding (EBF), (giving breast milk only without any solids or liquids), has proved to be very challenging in the South African context, although this infant feeding practice has been found to protect babies against diarrhoea and respiratory tract infections and to carry a lower risk of HIV infection than mixed feeding (breastfeeding combined with formula or solids). Study design: The PROMISE-EBF study is a multi-country cluster randomised trial to examine peer support to promote exclusive breastfeeding in Africa. For the South African site in the PROMISE-EBF study, three sites, Paarl, Rietvlei and Umlazi, were selected because of their different geographic settings and each site operated as a separate stratum for cluster selection and randomisation purposes. The clusters were then randomised into intervention and control arms making a total of 17 clusters in each arm. HIV positive and negative women in the intervention arm received support on their choice of infant feeding from the peer supporters who visited them at their homes while the women in the control group only received the standard infant feeding counselling and support provided by health care&nbsp / workers at health facilities. Data collection: Mothers were interviewed at recruitment during the antepartum period to establish eligibility, obtain informed consent and data on socio-economic status. Home visits were scheduled for data collection by trained data collectors at 3, 6, 12 and 24 weeks after birth. Analysis of results: This mini-thesis was a secondary analysis of the PROMISE-EBF data focusing on the South African data only. The data was adjusted for clustering and analysed using SAS. Comparison of variables between the intervention and control groups within sites was done. Results: A significant difference, regarding counselling and infant feeding practices, was observed among all women who received peer support compared to those who received the standard antenatal counselling, with more women in the intervention group (20.5%) practising EBF than those in the control group (12.8%) by Week 3. When the women‟s HIV status was considered, more than 65% of HIV positive and 40% of HIV negative women practised MF and EFF (giving formula milk only with no breast milk) throughout the study, respectively, regardless of the group they were in. For women who hadintended to practise EBF at recruitment, 33% in the control group and 20% in the intervention group actually practised EBF by Week 3. Regarding disclosure and feeding choice, 77.4% of women who had disclosed their HIV status actually practised MF versus 8.6% who practised EBF by Week 3.Conclusion: Community peer counselling should be strengthened as the results from this study showed that a high percentage of women who practised EBF were those who had received counselling, irrespective of their HIV status. The high percentage of HIV positive women who practised high risk feeding, despite receiving infant counselling, is of concern. Disclosure of the women‟s HIV status did not translate to them practising low risk infant feeding methods, which may suggest that there are other issues that determine the women‟s choice of infant feeding.</p>

Free-access acidified milk feeding is increasingly being adopted to feed dairy and veal calves. Acidification is used to preserve milk and facilitate free-access feeding. There is, however, little controlled research to support the adoption of free-access acidified milk feeding over traditional feeding programs. The objectives of this thesis were to describe the preweaned calf management and feeding practices used on dairy farms in Ontario, Canada, and to investigate the effects of milk replacer acidification and free-access feeding on the productivity and welfare of calves. A total of 140 Ontario dairy producers participated in a cross-sectional study and were surveyed about on-farm calf management and feeding practices. Results from this study documented that there are currently a range of management practices and several different feeding programs being used on farms. Colostrum and milk feeding management are the areas where the most progress has been made in recent years; however, several other aspects of calf management and feeding still warrant improvement. A pilot study was conducted to examine the effects of milk replacer acidification and free-access feeding on the nutrient intake, growth, rumen papillary development and behaviour of calves. A field study was designed to evaluate the effects of a free-access acidified milk replacer feeding program on the pre and postweaning health and growth of dairy and veal calves. A randomized controlled study was completed to investigate how milk replacer acidification, under free-access feeding conditions, affects the pre and postweaning performance and health of veal calves. Results from these studies demonstrated that milk replacer acidification limited calves’ intake of milk replacer by approximately 1 L/d, resulted in more fragmented feeding behaviour, promoted earlier solid feed intake and tended to support improved respiratory health, but had little impact on rumen development or long-term calf performance. Moreover, free-access feeding facilitated larger intakes of milk, resulted in fewer signs of hunger or frustration, and supported greater preweaning growth, but delayed the onset of solid feed consumption and appeared to negatively affect rumen development, compared to restricted feeding. Collectively, these results demonstrate that free-access acidified milk feeding promotes greater early life productivity and enhances calf welfare. / Ontario Ministry of Agriculture, Food and Rural Affairs, Dairy Farmers of Ontario, Ontario Veal Association, National Sciences and Engineering Research Council, Grober Nutrition and 3M Canada

<p>Promotion of exclusive breastfeeding (EBF), (giving breast milk only without any solids or liquids), has proved to be very challenging in the South African context, although this infant feeding practice has been found to protect babies against diarrhoea and respiratory tract infections and to carry a lower risk of HIV infection than mixed feeding (breastfeeding combined with formula or solids). Study design: The PROMISE-EBF study is a multi-country cluster randomised trial to examine peer support to promote exclusive breastfeeding in Africa. For the South African site in the PROMISE-EBF study, three sites, Paarl, Rietvlei and Umlazi, were selected because of their different geographic settings and each site operated as a separate stratum for cluster selection and randomisation purposes. The clusters were then randomised into intervention and control arms making a total of 17 clusters in each arm. HIV positive and negative women in the intervention arm received support on their choice of infant feeding from the peer supporters who visited them at their homes while the women in the control group only received the standard infant feeding counselling and support provided by health care&nbsp / workers at health facilities. Data collection: Mothers were interviewed at recruitment during the antepartum period to establish eligibility, obtain informed consent and data on socio-economic status. Home visits were scheduled for data collection by trained data collectors at 3, 6, 12 and 24 weeks after birth. Analysis of results: This mini-thesis was a secondary analysis of the PROMISE-EBF data focusing on the South African data only. The data was adjusted for clustering and analysed using SAS. Comparison of variables between the intervention and control groups within sites was done. Results: A significant difference, regarding counselling and infant feeding practices, was observed among all women who received peer support compared to those who received the standard antenatal counselling, with more women in the intervention group (20.5%) practising EBF than those in the control group (12.8%) by Week 3. When the women‟s HIV status was considered, more than 65% of HIV positive and 40% of HIV negative women practised MF and EFF (giving formula milk only with no breast milk) throughout the study, respectively, regardless of the group they were in. For women who hadintended to practise EBF at recruitment, 33% in the control group and 20% in the intervention group actually practised EBF by Week 3. Regarding disclosure and feeding choice, 77.4% of women who had disclosed their HIV status actually practised MF versus 8.6% who practised EBF by Week 3.Conclusion: Community peer counselling should be strengthened as the results from this study showed that a high percentage of women who practised EBF were those who had received counselling, irrespective of their HIV status. The high percentage of HIV positive women who practised high risk feeding, despite receiving infant counselling, is of concern. Disclosure of the women‟s HIV status did not translate to them practising low risk infant feeding methods, which may suggest that there are other issues that determine the women‟s choice of infant feeding.</p>

To determine the relationship between infant-feeding practices and diarrhoeal infections, a descriptive survey was conducted to infants between six to 12 months of age. A guided interview was conducted to 105 mothers of infants who attended the health facilities of Mbabane, Swaziland. The results show that breast-feeding is routinely practiced by the majority of mothers and exclusive breast-feeding is very low, but supplementary feed in the form of formula or solids are introduced by the majority of respondents within the first three months of life. Infants who were given colostrum and breast milk had fewer diarrhoeal attacks. Other factors, for example education and cultural factors influenced the feeding practices and number of diarrhoeal attacks. It is recommended that breast-feeding should be promoted as an important intervention in the control of diarrhoea / Health Studies / M.A. (Nursing Science)