Some HIV-positive women in Kenya are following cultural infant feeding practices, such as starting solid foods at an early age, instead of World Health Organization recommendations that infants born to HIV-positive women be exclusively breastfed for the first six months to improve their chances of survival, IRIN/PlusNews reports. The WHO guidelines call for exclusive breastfeeding in cases where safe replacement feeding is not possible or affordable. According to IRIN/PlusNews, some studies have shown that stopping breastfeeding too early is associated with higher mortality among HIV-exposed infants.
Elizabeth Achola, coordinator of the mother-to-child prevention treatment program at Maseno Mission Hospital, said that denial and the fact that some women do not disclose their HIV-positive status to spouses and relatives are challenges that health workers face. She said, "Most mothers who come here for antenatal visits are very reluctant to disclose their status to their husbands. In fact, most would rather come with other relatives than their husbands." Achola added, "Those who choose formula feeding are forced to breastfeed when they get home, and those who choose exclusive breastfeeding are forced to wean their children when it is still dangerous for them to do so." In addition, counseling women on the best feeding practices can be a challenge because few admit they are not following recommendations, IRIN/PlusNews reports. Stigma and cultural feeding practices also place pressure on women to risk transmitting HIV to their infants rather than reveal their HIV-positive status. Achola said, "If not tackled, (incorrect infant feeding) could erode the gains already made in preventing transmission amongst infants, especially in rural areas where traditional beliefs and stigma still hold sway." The Maseno University AIDS Control Unit and the Maseno Mission Hospital have created a support group for HIV-positive women with infants in an effort to address the issue (IRIN/PlusNews, 5/4).
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