HIV-Positive Mothers in Uganda Resort to Breastfeeding
August 22, 2003
A growing number of HIV-positive mothers in Uganda are breastfeeding their babies since UNICEF stopped donating free infant formula. Doctors implementing the nation's prevention of mother-to-child HIV transmission (PMTCT) project said on Aug. 7 that most of the women could not afford infant formula. UNICEF donated formula to babies born to HIV-positive mothers from 2000-2002, but was unhappy with the results. "People who are in need did not have access to it, and it was expensive so it was not sustainable," said Pirkko Heinonen, deputy UNICEF representative in Uganda.
In the PMTCT program, HIV-positive mothers receive nevirapine to reduce the risk of infecting their babies during labor. Mothers are then counseled and asked to choose between formula feeding and exclusive breastfeeding.
UNICEF said that nationally only 32 percent of the HIV-positive mothers opted for formula feeding. The rest chose to breastfeed either because of stigma or living conditions that made formula feeding risky, said Dorothy Ochola, UNICEF's PMTCT coordinator in Uganda. "Even among those who chose formula, many were breastfeeding at night for convenience, and it has been proved that mixed feeding increases the risk of transmitting HIV through breastmilk," said Ochola.
The Ministry of Health could not provide figures on how many mothers have turned to breastfeeding. However, the numbers are large. At Nsambya, one of the urban sites, 50 percent of the women formula fed their children last year, but this has now dropped to less than 20 percent.
On August 8, a national PMTCT conference in Kampala recommended that the Ministry of Health should procure infant formula. However, Saul Onyango, the national PMTCT coordinator, said: "Are we justified to add infant formula when our health centers don't have even the basic antenatal care drugs such as folic acid? In a resource-constrained system we have to be pragmatic and do what is possible."
08.16.03; Vol. 362; No. 9383: P. 542; Charles Wendo
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update. Visit the CDC's website to find out more about their activities, publications and services.