title: The acceptance and feasibility of replacement feeding at 6 months as an HIV prevention method in Lilongwe, Malawi: results from the BAN study.
abstract: International guidelines recommend EBF to age 6 months among HIV-infected mothers choosing to breast-feed and cessation thereafter if replacement feeding is acceptable, feasible, affordable, sustainable, and safe. When mothers wean, they are challenged to provide an adequate replacement diet. This study investigates the use and acceptability of a lipid-based nutrient supplement (LNS) as a breast-milk substitute when provided to infants (6-12 mo) of HIV-positive mothers, as part of the Breast-feeding, Antiretroviral, and Nutrition (BAN) Study. A sub-sample of mothers (n = 45) participated in interviews that explored EBF, weaning, and strategies to feed LNS. Mothers reported several weaning strategies, including gradual reduction of breast-feeding, expressing breast-milk into a cup, and separation of mother and child. LNS, a peanut-based micronutrient fortified paste, was highly accepted and incorporated into the traditional diet. Weaning is a feasible HIV prevention method among this population in Malawi when supported by the provision of LNS as a breast-milk substitute.
authors.affiliation: School of Public Health, University of North Carolina-Chapel Hill, USA. m.parker@cgiar.org
authors.forename: Megan E
authors.initials: ME
authors.lastname: Parker
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Bentley
authors.forename: Charles
authors.initials: C
authors.lastname: Chasela
authors.forename: Linda
authors.initials: L
authors.lastname: Adair
authors.forename: Ellen G
authors.initials: EG
authors.lastname: Piwoz
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Sascha
authors.initials: S
authors.lastname: Ellington
authors.forename: Dumbani
authors.initials: D
authors.lastname: Kayira
authors.forename: Alice
authors.initials: A
authors.lastname: Soko
authors.forename: Chimwemwe
authors.initials: C
authors.lastname: Mkhomawanthu
authors.forename: Martin
authors.initials: M
authors.lastname: Tembo
authors.forename: Francis
authors.initials: F
authors.lastname: Martinson
authors.forename: Charles M
authors.initials: CM
authors.lastname: Van der Horst
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001942:Breast Feeding; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D008895:Milk, Human; D009035:Mothers; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D014886:Weaning
chemical_list: D000998:Antiviral Agents