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The infant feeding practices of Human Immunodeficiency Virus positive women within the Prevention of Mother to Child Transmission program in Soweto, Johannesburg

MPH, Faculty of Health Sciences, University of theWitwatersrand, 2011 / Introduction: In South Africa, over 25% of all babies born each year are exposed to
HIV. The high antenatal HIV sero-prevalence rates coupled with high levels of maternal
morbidity and mortality advocate for high quality maternal and child health care, which
should include resilient PMTCT programs. This study aimed to explore infant feeding
practices selected by HIV-positive women enrolled on a PMTCT program and describe
some of the reasons for their choices, within the first 6 months postpartum. The study
also reports on infant feeding practice and HIV status of the infant.
Methodology: The study was a cross-sectional study which was carried out within the
Perinatal Research Unit at Chris Hani Baragwanath hospital in Soweto. A sample of 200
women enrolled in the PMTCT program was interviewed, using a semi-structured
questionnaire, during April 2007 – June 2007.
Results: The study revealed that 84.5% of the study population had received infant
feeding counseling. There was a high rate of exclusive formula feeding (EFF=84.5%),
with lower exclusive breastfeeding (EBF=14%) and mixed feeding (MF=1.5%) rates.
The corresponding HIV transmission rates were EFF – 26% (n=44/169); EBF – 75%
(n=21/28); MF – 100% (n=3/3). The study demonstrated that babies born to mothers who
did not receive information on infant feeding were twice as likely to be HIV positive
(OR=2.43), which was statistically significant. The study also showed that the timing of
the counseling was critical – all mothers who received counseling 6 weeks or more after
delivery had HIV-positive babies. The overwhelming majority of women (78%) indicated
that they would breast feed their babies if they were HIV-negative.
Conclusion: The study demonstrated the vital role of infant feeding counseling in
antenatal care and PMTCT programs. It illustrated that it was critically important that all
HIV-infected women receive infant feeding counseling as soon as possible after the HIV
diagnosis is made, prior to delivery and highlighted the importance of reinforcement of
infant feeding choice at every antenatal care visit, for every woman.
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The key recommendations focus on the need for:
• Improved Antenatal care for all pregnant women
• Improved care for HIV-positive pregnant women
• Improvements in infant feeding counseling for HIV positive women
• Integration of Maternal, Child health and PMTCT programs
• Intensification of ongoing prevention efforts
• The need for further research to:
o identify some of the reasons HIV positive women choose certain infant
feeding modalities throughout the country, and the challenges associated
with these; and
o critically evaluate the training that health care workers and counselors
receive, regarding infant feeding counseling.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/10422
Date16 September 2011
CreatorsJacobs Jokhan, Donna
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf, application/pdf

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