| dc.description.abstract | OBJECTIVE:
To assess breastfeeding modes and determinants in a prevention of mother-to-child transmission study.
DESIGN:
HIV-1-infected pregnant women from 5 sites in Burkina Faso, Kenya, and South Africa were enrolled in
the study that comprised 2 prospective cohorts and 1 randomized controlled trial. Women were
counseled to either breastfeed exclusively up to 6 months or formula feed from birth.
METHODS:
Determinants of breastfeeding initiation and continuation by 3 months postpartum were investigated
using multiple logistic regression analysis. Neonatal morbidity was defined as mother-reported fever,
diarrhea, or vomiting during the first month of life.
RESULTS:
Among 1028, 781 women (76%) initiated breastfeeding and 565 of 995 (56%) were still breastfeeding at
3 months postpartum (30% exclusively, 18% predominantly, and 8% partially). Study site (Durban,
Mombasa, and Nairobi compared with Bobo-Dioulasso), CD4 cell count (<200 cells/mm), secondary
schooling (compared with none), and emergency cesarean delivery (compared with vaginal delivery)
were independently associated with a lower probability of ever breastfeeding. The odds of still
breastfeeding by 3 months postpartum (among those breastfeeding by 1 month) were lower in
Mombasa, Nairobi, and Somkhele (compared with Bobo-Dioulasso) and among infants with neonatal
morbidity [0.60 (0.37-0.976)]. The odds of exclusive breastfeeding (EBF) by 3 months (if EBF by 1 month)
were lower in Mombasa and Nairobi, in ill neonates [0.54 (0.31-0.93)] and boys [0.51 (0.34-0.77)].
CONCLUSIONS:
EBF was of short duration, particularly for boys. The importance of neonatal morbidity for breastfeeding
cessation requires further investigation. Infant feeding counseling might need adaptation to better
support mothers of boys and ill neonates. | |
