Longitudinal infant feeding study: constraints to exclusive breast feeding.
Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC497)
Bland RM, Rollins NC, Solarsh G, Tomkins A R.M. Bland, Africa Centre, PO Box 198, Mtubatuba 3935, Kwazulu Natal, South Africa, Tel.: +27 35 550 0158, Fax: +27 35 550 1674, E-mail: blandr@mrc.ac.za
Exclusive breastfeeding (EBF) is recognised as a child survival strategy. Recent evidence also suggests that EBF may carry no added risk of mother to child transmission of HIV1 compared to non-human milk(1). In preparation for a definitive study to test this hypothesis, a prospective study of infant feeding practices in rural Kwazulu Natal was conducted to understand the constraints to EBF. Infant feeding practices and the reasons for supplementing breast milk were recorded within 100 hours of delivery, and at subsequent weekly home visits. 113 babies have so far been delivered of 142 women recruited antenatally. At recruitment, 39% of women intended to exclusively breastfeed their infants to 6 weeks, and only 16% to 12 weeks of age. In practice, 47% (53/113) of mothers supplemented breastmilk within the first 48 hours of life, 64% (34/53) because of "reported" insufficient breastmilk. Only 18% of infants (21/113) were put to the breast within 1 hour of delivery, and 41% (47/113) had a delay of at least 4 hours. By 6 weeks of age only 5% (3/52) of infants had been exclusively breast fed since birth. Additional feeds had been introduced mainly because the baby was unsatisfied (59%) or there was perceived insufficient breastmilk (13%). Antenatally, 39% of women intended to return to work and 16% to school in the first 6 months post delivery. However, this was given as a reason for supplementation in only 8% and 5% of cases respectively. EBF is uncommon in the very young infant. Separation due to work and school are uncommon reasons for early supplementation. The perception of insufficient milk, failure to put the baby to the breast immediately after delivery, and concerns about an unsatisfied infant are important early constraints to EBF. Any strategy to promote EBF to reduce postnatal transmission of HIV1 must target mothers, and those supporting them, in the antenatal and early neonatal periods.
Keywords: AEGIS, Breast Feeding, Longitudinal Studies, Mothers, Bottle Feeding, Milk, Human, Infant Food, Prospective Studies, Infant Nutrition, Activities of Daily Living, Infant Care, Postnatal Care, Infant, Human, Female, Child, rehabilitation, therapy 000709
WeOrC497
