AEGiS-14IAC: Adequacy of feeding recommendations for infants of HIV-infected mothers: assessment of nutrient content, cost and preparation time of breastmilk replacements in the South African context.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Adequacy of feeding recommendations for infants of HIV-infected mothers: assessment of nutrient content, cost and preparation time of breastmilk replacements in the South African context.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. MoOrF1030)

Papathakis PC, Rollins NC
Africa Centre for Health and Population Studies, Mtubatuba, South Africa

ISSUES: Little is known about nutritional adequacy and feasibility of several feeding options presented in the WHO guidelines for infants of HIV-infected mothers.

DESCRIPTION: To explore the suitability of the current feeding recommendations for infants of HIV-infected mothers in the South African context, we compared the nutritional adequacy (micronutrients and essential fatty acids), cost and preparation time of replacement milks suggested in the WHO HIV and Infant Feeding Counselling guidelines for the rural KwaZulu Natal region of South Africa.

ISSUES: Powdered and liquid full cream milk (FCM) mixed with water, sugar and micronutrient supplement, provide less than 33% of the estimated Adequate Intake (AI) for vitamins E, C, and folic acid, and pantothenic acid and less than 80% of zinc, copper, selenium and vitamin A. These preparations provide 19% of linoleic acid and 58% of linolenic acid recommended per 450 ml mixture. Use of FCM represents approximately 20% of monthly income, while use of commercial formula represents 35%. Including time to collect firewood and water, build a fire, boil the water, wash the utensils, and prepare the milk mixture, it took between 20-30 minutes to prepare 120 ml.

RECOMMENDATIONS: There are no powdered or liquid full cream milk replacement feeds in this region of South Africa that meet all the estimated micronutrient and essential fatty acid requirements of infants less than 6 months. Replacement milks are expensive relative to average income, and may require a significant portion of the day to prepare. Revisions of the WHO course replacement milk options are needed. For HIV-infected mothers to make an informed choice on infant feeding options, it is important to discus the estimated local financial cost of replacement in relation to income, and the time cost. If replacement milk is chosen, the caretaker will need continuing support on its appropriate preparation.

Keywords: AEGIS, HIV, HIV Infections, Mothers, HIV Seropositivity, Bottle Feeding, Infant Nutrition, Infant Food, Time, Nutritional Support, Milk, South Africa, Infant, Human, Animal, economics, therapy

020707
MoOrF1030