OBJECTIVES: We report on a nonrandomized intervention cohort study to increase exclusive breast-feeding rates for 6 months after delivery in HIV-positive and HIV-negative women in KwaZulu-Natal, South Africa. METHODS: Lay counselors visited women to support exclusive breast-feeding: four times antenatally, four times in the first 2 weeks postpartum and then fortnightly to 6 months. Daily feeding practices were collected at weekly intervals by separate field workers. Cumulative exclusive breast-feeding rates from birth were assessed by Kaplan-Meier analysis and association with maternal and infant variables was quantified in a Cox regression analysis. FINDINGS: One thousand, two hundred and nineteen infants of HIV-negative and 1217 infants of HIV-positive women were followed postnatally. Median duration of exclusive breast-feeding was 177 (R = 1-180; interquartile range: 150-180) and 175 days (R = 1-180; interquartile range: 137-180) in HIV-negative and HIV-positive women, respectively. Using 24-h recall, exclusive breast-feeding rates at 3 and 5 months were 83.1 and 76.5%, respectively, in HIV-negative women and 72.5 and 66.7%, respectively, in HIV-positive women. Using the most stringent cumulative data, 45% of HIV-negative and 40% of HIV-positive women adhered to exclusive breast-feeding for 6 months. Counseling visits were strongly associated with adherence to cumulative exclusive breast-feeding at 4 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% confidence interval: 1.56-2.74, P < 0.0001; HIV-positive women: adjusted odds ratio: 2.86, 95% CI 2.13-3.83, P < 0.0001). CONCLUSION: It is feasible to promote and sustain exclusive breast-feeding for 6 months in both HIV-positive and HIV-negative women, with home support from well trained lay counselors.
OBJECTIVES: We report on a nonrandomized intervention cohort study to increase exclusive breast-feeding rates for 6 months after delivery in HIV-positive and HIV-negative women in KwaZulu-Natal, South Africa. METHODS: Lay counselors visited women to support exclusive breast-feeding: four times antenatally, four times in the first 2 weeks postpartum and then fortnightly to 6 months. Daily feeding practices were collected at weekly intervals by separate field workers. Cumulative exclusive breast-feeding rates from birth were assessed by Kaplan-Meier analysis and association with maternal and infant variables was quantified in a Cox regression analysis. FINDINGS: One thousand, two hundred and nineteen infants of HIV-negative and 1217 infants of HIV-positive women were followed postnatally. Median duration of exclusive breast-feeding was 177 (R = 1-180; interquartile range: 150-180) and 175 days (R = 1-180; interquartile range: 137-180) in HIV-negative and HIV-positive women, respectively. Using 24-h recall, exclusive breast-feeding rates at 3 and 5 months were 83.1 and 76.5%, respectively, in HIV-negative women and 72.5 and 66.7%, respectively, in HIV-positive women. Using the most stringent cumulative data, 45% of HIV-negative and 40% of HIV-positive women adhered to exclusive breast-feeding for 6 months. Counseling visits were strongly associated with adherence to cumulative exclusive breast-feeding at 4 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% confidence interval: 1.56-2.74, P < 0.0001; HIV-positive women: adjusted odds ratio: 2.86, 95% CI 2.13-3.83, P < 0.0001). CONCLUSION: It is feasible to promote and sustain exclusive breast-feeding for 6 months in both HIV-positive and HIV-negative women, with home support from well trained lay counselors.
Authors: Nigel C Rollins; Renaud Becquet; Ruth M Bland; Anna Coutsoudis; Hoosen M Coovadia; Marie-Louise Newell Journal: AIDS Date: 2009-03-27 Impact factor: 4.177
Authors: Meera K Chhagan; Jan Van den Broeck; Kany-Kany A Luabeya; Nontobeko Mpontshane; Andrew Tomkins; Michael L Bennish Journal: BMC Public Health Date: 2010-03-18 Impact factor: 3.295
Authors: Karim P Manji; Christopher Duggan; Enju Liu; Ronald Bosch; Rodrick Kisenge; Said Aboud; Ronald Kupka; Wafaie W Fawzi Journal: J Trop Pediatr Date: 2016-03-15 Impact factor: 1.165
Authors: Renaud Becquet; Ruth Bland; Valériane Leroy; Nigel C Rollins; Didier K Ekouevi; Anna Coutsoudis; François Dabis; Hoosen M Coovadia; Roger Salamon; Marie-Louise Newell Journal: PLoS One Date: 2009-10-16 Impact factor: 3.240