Mothers Knowledge and other factors that influence selection of feeding options for infants aged 0-6 months with special emphasis on mother to child transmission of HIV in Kenyatta National Hospital, Nairobi, Kenya.
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In September - December 2000, a cross-sectional descriptive study was carried out with an aim of identifying factors that determine selection of feeding options for infants 0-6 months attending Paediatric Demonstration clinic at Kenyatta National Hospital, Nairobi, Kenya. A structured questionnaire administered to mothers was the principal tool of investigation. Purposive sampling of individual mothers with children 0-6 months was done among all mothers with children registered in the clinic until a sample size of 176 mothers was achieved. The following were the objectives of this study; to determine potential demographic socio-economic factors associated with choice of feeding options. To determine mothers knowledge of MTCT of HIV and its prevention through selection of suitable infant feeding options for 0-6 months infants. To determine the feeding option choices if the mother was HIV positive in hypothetical situations. Finally, to determine the methods of food preparation and handling of foods for 0-6 months infants. The questionnaire was filled as each mother was being interviewed. Information on mother's knowledge of feeding options for 0-6 month's infants and the actual feeding practices for the infants was obtained. Demographic and socio-economic data was also collected as part of the same questionnaire. SPSS/PC + computer package was used for data entry and analysis. The results of this study show that breast milk was the first food given to infants by about half of the mothers although most of them adopted mixed feeding before 6 months. Among the feeding options that were selected, breast-feeding was the most preferred feeding option by about half (48%) of women selecting it. Porridge and sweetened water were selected by (12%). Marital status was significantly associated with the type of feeding option selected (P=O.OOl). It was also found that the decision-maker status significantly determined the type of feeding option selected for an infant in relation to the decision making status (P=O.Ol). Mothers who had knowledge of maternal transmission HIV and infant feeding options significantly made better choices compared to those that lacked that knowledge (P=0.007). The following are the rec mmendations. The government and other agencies should and redesign and embark on campaigns that will address behaviour and attitude change towards prevention of HIV and exclusive breast-feeding for 0-6 months infants. All mothers should be discouraged from mixed feeding for the first six months. Women should be empowered with child feeding knowledge and how to promptly address any breast feeding problems in order to make informed decisions. MTCT clinics should engage the services of nutrition counsellors and breast health education should be introduced in the Maternal and Child health services for successful breast-feeding. Lactation management courses should be expanded to target health workers working in all paediatric and obstetrics services. Further research is needed to study the effect of abrupt weaning from the breast on infants less than 6 months and effects of modified human and cow milk on 0-6 months infants. A comparative study should be done on infants from HIV positive mothers on replacement feeds and those who are on exclusive breast-feeding less than six months.