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<p>The aim of this study was to describe the demographic and socio-economic factors influencing infant feeding practices in the Amathola district, South Africa. A survey was chosen as the design method and a structured questionnaire was used to collect information regarding the socio-economic and demographic factors and related infant feeding choices. The study population consisted of 100 women with infants up to the age of 14 weeks, who brought their infant for immunization at the selected community health clinic (the largest clinic in the Mdantsane area). Infants up to the age of 14 weeks were used because all the visits up to 14 weeks coincide with the local immunization program, and according to WHO guidelines all infants should be exclusively breastfed until they reach the age of 6 months of age. The study found that there are many families in the Mdantsane area that suffer from poor conditions and inadequate services such as a lack of electricity, working taps or flush toilets within their dwelling, which in turn has an impact on infant feeding practices. It was found that even in poor demographic and socio-economic conditions, formula feeding is still the chosen feeding practice for the majority of mothers.</p>

Despite global efforts, exclusive breastfeeding is rarely practiced in South Africa where infants are at risk of diarrheal infections, malnutrition and HIV transmission. The present study was conceptualized within the context of a multi-country, cluster randomized community-based behavioural intervention known as PROMISE-EBF in South Africa, Burkina Faso, Zambia and Uganda (www.clinicaltrials.gov, no: NCT00397150). The aim of this thesis was to identify and describe contextual factors that are important for the effectiveness of community-based peer counselling with a special focus on the promotion of exclusive breast and formula feeding. This thesis identifies the paradoxes and discrepancies embedded in the notion of community-based “peer” counselling approach, especially in the South African context of poverty, HIV and social distrust. Peer counselling, while perceived useful, was associated with social distrust which might have resulted in reduced effectiveness of the intervention. The thesis further illustrates that, while there is strong support for breast feeding, there was a general openness for early introduction of commercial foods and liquids. Mothers’ perceptions on infant feeding and peer counselling varied substantially according to HIV-status and geographical area. Nevertheless, the infant feeding peer counselling approach neither modified the mothers’ perceptions on feeding nor its associated barriers. Thus, several important barriers to exclusive breastfeeding including the risk for HIV stigmatization still remain. The results of this thesis highlight the need to rethink current approaches to the promotion of exclusive breastfeeding. It further draws attention to the gap between theoretical assumptions inherent in health interventions and the actual dynamic processes and realties of women in low-income high HIV settings.

<p>The aim of this study was to describe the demographic and socio-economic factors influencing infant feeding practices in the Amathola district, South Africa. A survey was chosen as the design method and a structured questionnaire was used to collect information regarding the socio-economic and demographic factors and related infant feeding choices. The study population consisted of 100 women with infants up to the age of 14 weeks, who brought their infant for immunization at the selected community health clinic (the largest clinic in the Mdantsane area). Infants up to the age of 14 weeks were used because all the visits up to 14 weeks coincide with the local immunization program, and according to WHO guidelines all infants should be exclusively breastfed until they reach the age of 6 months of age. The study found that there are many families in the Mdantsane area that suffer from poor conditions and inadequate services such as a lack of electricity, working taps or flush toilets within their dwelling, which in turn has an impact on infant feeding practices. It was found that even in poor demographic and socio-economic conditions, formula feeding is still the chosen feeding practice for the majority of mothers.</p>

The benefits of breastfeeding are well known. It has been shown that HIV is transmitted through breast milk. The HIV epidemic is threatening exclusive breastfeeding in South Africa. It is important that mothers make the right infant feeding choice. There are three basic infant feeding methods available for HIV infected mothers namely; breastfeeding, replacement feeding or formula feeding and heat treatment of breast milk. There are many risk factors for the transmission of HIV through breast milk. Exclusive breastfeeding may reduce the risk of mother-to-child-transmission, compared with mixed feeding. This can only take place when breastfeeding is done safely and not mixed with other food or drinks. There are many factors that influence a mother's decision to breastfeed, for example personal, social, cultural factors, facilities, environmental factors, knowledge about breastfeeding, mass media and friends. There are also many sources of information about infant feeding methods. The aim of this study was to determine which factors influence the decision on the early infant feeding choice of women who delivered at the Lower Umfolozi District War Memorial Hospital in Empangeni, KwaZulu-Natal. This may help to understand what factors health professionals should focus on in promoting appropriate infant feeding methods. A structured questionnaire was completed by a 100 women and focus group discussions were held with 22 women who delivered at the Lower Umfolozi District War Memorial Hospital. Most of the mothers (72%) did choose breastfeeding, and 58% of these mothers intended to breastfeed for only six months. The majority of the women (97%) received counseling about their infant feeding method, mostly from a health care worker at the clinic. One-third of the women (33%) were influenced by health care professionals on deciding on their infant feeding method and 44% of the participants indicated that no-one influenced them and that they decided themselves. In the focus group discussions the fear of transmission of HIV through breast milk was stated as an important reason why mothers should choose replacement feeding. In conclusion the most important results are that significantly more HIV-infected mothers chose replacement feeding as infant feeding method, and mothers who chose breastfeeding were significantly older than mothers who selected replacement feeding and they made their infant feeding decision significantly earlier than those who chose replacement feeding. According to the focus group discussion results the communities also felt that the HIV-infected mothers should not breastfeed their infants due to the fact that the virus can be transmitted through breast milk. Health professionals should still provide all the necessary information about exclusive breastfeeding for the first six months, even where the prevalence of HIV is high. In most of these areas replacement feeding will not be acceptable, feasible, affordable, sustainable and safe, due to lack of safe water, sanitation and the poor socio-economic status of these people. The dangers of mixed feeding should be emphasized. Most of the women in this study received information from health care workers and family. It is important that family members are included when information is given to women of child-bearing age. Health care workers need appropriate training to ensure that they give the right messages about safe infant feeding to the mothers. / Thesis (M.Sc. (Dietetics)--North-West University, Potchefstroom Campus, 2009.

The benefits of breastfeeding are well known. It has been shown that HIV is transmitted through breast milk. The HIV epidemic is threatening exclusive breastfeeding in South Africa. It is important that mothers make the right infant feeding choice. There are three basic infant feeding methods available for HIV infected mothers namely; breastfeeding, replacement feeding or formula feeding and heat treatment of breast milk. There are many risk factors for the transmission of HIV through breast milk. Exclusive breastfeeding may reduce the risk of mother-to-child-transmission, compared with mixed feeding. This can only take place when breastfeeding is done safely and not mixed with other food or drinks. There are many factors that influence a mother's decision to breastfeed, for example personal, social, cultural factors, facilities, environmental factors, knowledge about breastfeeding, mass media and friends. There are also many sources of information about infant feeding methods. The aim of this study was to determine which factors influence the decision on the early infant feeding choice of women who delivered at the Lower Umfolozi District War Memorial Hospital in Empangeni, KwaZulu-Natal. This may help to understand what factors health professionals should focus on in promoting appropriate infant feeding methods. A structured questionnaire was completed by a 100 women and focus group discussions were held with 22 women who delivered at the Lower Umfolozi District War Memorial Hospital. Most of the mothers (72%) did choose breastfeeding, and 58% of these mothers intended to breastfeed for only six months. The majority of the women (97%) received counseling about their infant feeding method, mostly from a health care worker at the clinic. One-third of the women (33%) were influenced by health care professionals on deciding on their infant feeding method and 44% of the participants indicated that no-one influenced them and that they decided themselves. In the focus group discussions the fear of transmission of HIV through breast milk was stated as an important reason why mothers should choose replacement feeding. In conclusion the most important results are that significantly more HIV-infected mothers chose replacement feeding as infant feeding method, and mothers who chose breastfeeding were significantly older than mothers who selected replacement feeding and they made their infant feeding decision significantly earlier than those who chose replacement feeding. According to the focus group discussion results the communities also felt that the HIV-infected mothers should not breastfeed their infants due to the fact that the virus can be transmitted through breast milk. Health professionals should still provide all the necessary information about exclusive breastfeeding for the first six months, even where the prevalence of HIV is high. In most of these areas replacement feeding will not be acceptable, feasible, affordable, sustainable and safe, due to lack of safe water, sanitation and the poor socio-economic status of these people. The dangers of mixed feeding should be emphasized. Most of the women in this study received information from health care workers and family. It is important that family members are included when information is given to women of child-bearing age. Health care workers need appropriate training to ensure that they give the right messages about safe infant feeding to the mothers. / Thesis (M.Sc. (Dietetics)--North-West University, Potchefstroom Campus, 2009.

South Africa recently changed infant feeding policy within Prevention of Mother to Child Transmission (PMTCT) of HIV from free formula to recommendation of breastfeeding for all. The country is evaluating the role of Community Health Workers (CHWs) in supporting mothers and newborns. The aim of this thesis is to explore perceptions of household members on the value given to and the social forces behind formula feeding in light of the recent policy change, and to assess the effect of a community-based package of maternal and newborn care delivered by CHWs on HIV-free survival and exclusive and appropriate infant feeding up to 12 weeks of age. Studies were conducted in a high HIV prevalence township. Focus group discussions were performed (grandmothers, fathers and teenage mothers) and in-depth interviews with HIV-positive and HIV-negative mothers. Perceptions of household members on the formula policy change were explored and the value household members place on formula feeding and circumstances that drive it. In a cluster-randomized trial (15 intervention, 15 control clusters) CHWs provided two antenatal and five post-natal home visits to support and promote PMTCT activities. There were misunderstandings by community members on the free formula policy change. Mothers transferred the motherhood role to their mothers while partners provided inadequate financial support, leading to risky mixed feeding. Teenage mothers rarely breastfed their infants due to perceived constraints including embarrassment, sagging breasts and loss of freedom and boyfriends. At 12 weeks of age the intervention had doubled exclusive breastfeeding (EBF) (28% vs. 14%) and slightly increased infant weight and length. No difference was seen between study arms in HIV-free survival. The effect on EBF at12 weeks did not differ with maternal education or wealth levels, but was higher among HIV-negative mothers.  Focusing on teenage mothers breastfeeding challenges, involvement of grandmothers and fathers in infant feeding decision-making, improving communication strategies on policy change and breastfeeding to the community and health workers and CHWs home visits supporting PMTCT activities are important for infant feeding and child health.

Magister Curationis - MCur / The aim of this study was to describe the demographic and socio-economic factors influencing infant feeding practices in the Amathola district, South Africa. A survey was chosen as the design method and a structured questionnaire was used to collect information regarding the socio-economic and demographic factors and related infant feeding choices. The study population consisted of 100 women with infants up to the age of 14 weeks, who brought their infant for immunization at the selected community health clinic (the largest clinic in the Mdantsane area). Infants up to the age of 14 weeks were used because all the visits up to 14 weeks coincide with the local immunization program, and according to WHO guidelines all infants should be exclusively breastfed until they reach the age of 6 months of age. The study found that there are many families in the Mdantsane area that suffer from poor conditions and inadequate services such as a lack of electricity, working taps or flush toilets within their dwelling, which in turn has an impact on infant feeding practices. It was found that even in poor demographic and socio-economic conditions, formula feeding is still the chosen feeding practice for the majority of mothers. / South Africa

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