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


METHODS
A cross-sectional survey of infant feeding behaviours.


METHODS
Four clinics in greater Dar es Salaam in early 2008.


METHODS
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.
Young
Sera L
SL
Department of Pediatrics, University of California Davis Medical Center, Ticon II Building, Suite 334, 2516 Stockton Blvd, Davis, Sacramento, CA 95817, USA. slyo@ucdavis.edu
Israel-Ballard
Kiersten A
KA
Dantzer
Emily A
EA
Ngonyani
Monica M
MM
Nyambo
Margaret T
MT
Ash
Deborah M
DM
Chantry
Caroline J
CJ
D000293:Adolescent; D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000453:epidemiology* / Q000706:statistics & numerical data; D053198:Child Nutrition Sciences / Q000193:education; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006679:HIV Seropositivity / Q000635:transmission; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000032:analysis / Q000592:standards; D041943:Infant Formula / Q000008:administration & dosage; D007228:Infant Nutrition Disorders / Q000517:prevention & control*; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008895:Milk, Human / Q000821:virology; D009035:Mothers / Q000193:education*; D009753:Nutritive Value; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult