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World News - Women
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SOUTH AFRICA:
"Intervention to Promote Exclusive Breast-Feeding for
the First Six Months of Life in a High HIV Prevalence Area"
AIDS Vol. 22; No. 7: P. 883-891, (04.23.2008) Ruth M. Bland; Kirsty E. Little;
Hoosen M. Coovadia; Anna Coutsoudis; Nigel C. Rollins; Marie-Louise Newell
The authors reported on a nonrandomized intervention cohort study designed to
increase exclusive breast-feeding rates for six months post-delivery in
HIV-positive and HIV-negative women in KwaZulu-Natal, South Africa.
CDC Summary
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SOUTH AFRICA:
"Intervention to Promote Exclusive Breast-Feeding for
the First Six Months of Life in a High HIV Prevalence Area"
AIDS Vol. 22; No. 7: P. 883-891, (04.23.2008) Ruth M. Bland; Kirsty E. Little;
Hoosen M. Coovadia; Anna Coutsoudis; Nigel C. Rollins; Marie-Louise Newell
The authors reported on a nonrandomized intervention cohort study designed to
increase exclusive breast-feeding rates for six months post-delivery in
HIV-positive and HIV-negative women in KwaZulu-Natal, South Africa.
To support exclusive breast-feeding, lay counselors visited the women four times
antenatally, four times in the first two weeks postpartum, and then once every
two weeks until six months. Separate field workers collected daily feeding
practices at weekly intervals. Cumulative exclusive breast-feeding rates from
birth were assessed using Kaplan-Meier analysis, and the association with
maternal and infant variables was quantified via Cox regression analysis.
A total of 1,219 infants of HIV-negative and 1,217 infants of HIV-positive women
were followed. Median duration of exclusive breast-feeding was 177 days
(R=1-180; interquartile range: 150-180) for HIV-negative women and 175 days
(R=1-180; interquartile range: 137-180) for HIV-positive women. Using 24-h
recall, exclusive breast-feeding rates at three and five months were 83.1 and
76.5 percent, respectively, in HIV-negative women and 72.5 and 66.7 percent,
respectively, in HIV-positive women. Applying the most stringent cumulative
data, 45 percent of HIV-negative and 40 percent of HIV-positive women adhered to
exclusive breast-feeding for six months. “Counseling visits were strongly
associated with adherence to cumulative exclusive breast-feeding at four months,
those who had received the scheduled number of visits were more than twice as
likely to still be exclusively breast-feeding than those who had not
(HIV-negative women: adjusted odds ratio: 2.07, 95 percent confidence interval:
1.56-2.74, P<0.0001; HIV-positive women: adjusted odds ratio: 2.86; 95 percent
CI 2.13-3.83, P<0.0001).
Promoting and sustaining exclusive breast-feeding for six months is feasible in
both HIV-positive and HIV-negative women with home support from well-trained lay
counselors, the authors concluded.
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