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Multicenter Study
. 2010 Dec;13(12):2027-33.
doi: 10.1017/S1368980010001539. Epub 2010 Jun 29.

Infant feeding practices among HIV-positive women in Dar es Salaam, Tanzania, indicate a need for more intensive infant feeding counselling

Sera L Young  1 , Kiersten A Israel-Ballard, Emily A Dantzer, Monica M Ngonyani, Margaret T Nyambo, Deborah M Ash, Caroline J Chantry
Affiliations
Multicenter Study

Infant feeding practices among HIV-positive women in Dar es Salaam, Tanzania, indicate a need for more intensive infant feeding counselling

Sera L Young et al. Public Health Nutr. 2010 Dec.

Abstract

Objective: To assess feeding practices of infants born to HIV-positive women in Dar es Salaam, Tanzania. These data then served as a proxy to evaluate the adequacy of current infant feeding counselling.

Design: A cross-sectional survey of infant feeding behaviours.

Setting: Four clinics in greater Dar es Salaam in early 2008.

Subjects: A total of 196 HIV-positive mothers of children aged 6-10 months recruited from HIV clinics.

Results: Initiation of breast-feeding was reported by 95·4 % of survey participants. In the entire sample, 80·1 %, 34·2 % and 13·3 % of women reported exclusive breast-feeding (EBF) up to 2, 4 and 6 months, respectively. Median duration of EBF among women who ever breast-fed was 3 (interquartile range (IQR): 2·1, 4·0) months. Most non-breast-milk foods fed to infants were low in nutrient density. Complete cessation of breast-feeding occurred within 14 d of the introduction of non-breast-milk foods among 138 of the 187 children (73·8 %) who had ever received any breast milk. Of the 187 infants in the study who ever received breast milk, 19·4 % received neither human milk nor any replacement milks for 1 week or more (median duration of no milk was 14 (IQR: 7, 152) d).

Conclusions: Infant feeding practices among these HIV-positive mothers resulted in infants receiving far less breast milk and more mixed complementary feeds than recommended, thus placing them at greater risk of both malnutrition and HIV infection. An environment that better enables mothers to follow national guidelines is urgently needed. More intensive infant feeding counselling programmes would very likely increase rates of optimal infant feeding.

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Conflict of interest statement

None of the authors had any conflicts of interest.

Figures

Fig. 1
Fig. 1
Survival of exclusive (——), predominant (– – –) and any breast-feeding (- - - - -) up to 6 months among 196 infants born to HIV-positive women in Dar es Salaam, Tanzania
Fig. 2
Fig. 2
Median and interquartile range of age in months at introduction of non-breast-milk foods among infants born to HIV-positive women in Dar es Salaam, in descending order of frequency (n 196); *proportion of infants ever fed item
See this image and copyright information in PMC

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