Qualitative and quantitative research methods were employed to evaluate the acceptability and feasibility of HIV-1 infected, urban South African mothers being able to feed their infants heat-treated expressed breast milk (HTEBM). Nutritional status assessment of HIV-infected breastfeeding mothers (n=84) indicated that maternal status was not compromised; mean body mass index 26.8 (4.0) kg/m2, triceps skinfold 14.8 (5.50) mm and hemoglobin 11.6 (1.49) g/dL. However, severely immunocompromised mothers (CD4 + < 200 cells/mm3) were more likely to be anemic. Breastmilk viral loads were also higher in mothers with lower CD4+ cell counts. Community based inquiry on the acceptability of HTEBM was accomplished through in-depth interviews of participants (n=31), at the individual (mothers), family (partners, grandparents, mothers-in-law) and at the community level (traditional healers, daycare worker, health care counselors). Although an unfamiliar concept for all interviewed, overall, HTEBM was found to be an acceptable feeding choice regardless of respondents' gender, age, maternal status, family or community role. Further, data indicated mothers rarely received quality infant feeding counseling, consequently mixed feeding, a high risk for HIV transmission, was a common practice. In a pilot longitudinal study, using mixed-methods, the feasibility of mothers successfully implementing a modified breastfeeding intervention (6 months exclusive breastfeeding (EBF), cessation of breastfeeding, followed by use of HTEBM with complementary diet) was evaluated. The majority of mothers (36/66) practiced EBF for 6 months, 42% of whom also used HTEBM, expressing a range of approximately, 65 ml to 600 ml of breastmilk daily, for varying durations (2 weeks to 5 months). Mothers did not experience breast pathology. Home visits were highly enabling as was disclosure of HIV status to a partner. This is the first study to demonstrate that use of HTEBM is a feasible infant feeding option for HIV infected women. HTEBM may offer one solution to reduce vertical transmission of HIV and help maintain nutritional adequacy, as a component of complementary feeding.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.103386 |
| Date | January 2007 |
| Creators | Sibeko, Lindiwe Nobesuthu. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (School of Dietetics and Human Nutrition.) |
| Rights | © Lindiwe Nobesuthu Sibeko, 2007 |
| Relation | alephsysno: 002763694, proquestno: AAINR50996, Theses scanned by UMI/ProQuest. |
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