Infant feeding practices of women in a perinatal HIV-1 prevention study in Nairobi, Kenya.
OBJECTIVE
To determine feeding practices and nutritional status of infants born to HIV-1-infected women.


METHODS
Feeding plans and practices were evaluated by questionnaires and focus group discussions. Infants were weighed at 1 and 6 weeks and tested for HIV-1 at 6 weeks.


RESULTS
Of 128 women seen after delivery, 111 completed the study. Mothers who planned to breast feed were more likely to feed their infants as planned (86% vs. 55%; P < 0.001). Women opted to breast feed due to financial constraints, partner influence, and fear of losing confidentiality. Women who reported that their partners were willing to have HIV-1 testing were less likely to be breast feeding at 6 weeks (odds ratio [OR] = 0.3, 95% confidence interval [CI]: 0.1-0.8; P = 0.01). At 6 weeks, more infants were mixed fed (31% vs. 21%; P = 0.05) than at 1 week. Lower infant weight at 6 weeks was associated with not breast feeding (P = 0.001), HIV-1 infection (P = 0.05), birth weight <3000 g (P = 0.01), maternal employment (P = 0.02), and paying <$12.5 per month in house rent (among infants not breast fed; P = 0.05).


CONCLUSIONS
Replacement feeding was difficult, particularly without partner support in HIV-1 testing. Mixed feeding was common and increased by 6 weeks. Mothers of low socioeconomic status who opt not to breast feed require support to avoid nutritional compromise of infants.
Kiarie
James N
JN
Department of Obstetrics and Gynecology, University of Nairobi, PO Box 3085-00506, Nairobi, Kenya. jkiarie@swiftkenya.com
Richardson
Barbra A
BA
Mbori-Ngacha
Dorothy
D
Nduati
Ruth W
RW
John-Stewart
Grace C
GC
D000328:Adult; D001724:Birth Weight; D001903:Bottle Feeding; D001942:Breast Feeding / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D007630:Kenya / Q000453:epidemiology; D009752:Nutritional Status; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011446:Prospective Studies