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Medical News

Intervention to Promote Exclusive Breast-Feeding for the First Six Months of Life in a High HIV Prevalence Area

May 7, 2008

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, PPromoting 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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Adapted from:
4.23.2008; Vol. 22; No. 7: P. 883-891; Ruth M. Bland, Kirsty E. Little, Hoosen M. Coovadia, Anna Coutsoudis, Nigel C. Rollins, Marie-Louise Newell

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
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