Guidelines for promoting supplementary infant feeding techniques among HIV-positive mothers

Vertical transmission of HIV is still a growing concern in South Africa. Breastfed infants are still at risk as HIV is present in breast milk, leaving HIV-positive mothers unsure of the best feeding option for their infants. However, there are various infant feeding techniques that HIV-positive mothers can use to supplement breastfeeding and flash-heat is one of them. Flash-heat is heat treating expressed breast milk to deactivate HIV for infant feeding. This study explored the possibility of HIV-positive mothers to practice flash-heating method for their infants exclusively for four months as a strategy to prevent vertical transmission of HIV. A descriptive, explorative and contextual design using a mixed method was used to obtain data from mothers in a post natal ward at Tembisa hospital. The mixed method used was useful in identifying the number of HIV-positive mothers who would adopt the flash-heat technique, the characteristics of mothers whom the technique could be promoted to, the factors that influence/affect the choice of infant feeding for these mothers, as well as their feelings associated with the feeding technique. Most (74%) mothers had a positive response to the flash-heat technique compared to 10% who were uncertain. They believed that heat treating their breast milk would result in their infants being HIV-free. In addition they believed that this method was cheaper than formula feeding and expressed positive feelings about touching their breast milk while expressing with no adverse feelings of expressing into a glass jar. Furthermore, findings of this study indicated that HIV-positive mothers in a public health facility would adopt flash-heat as an alternative infant feeding method. Thus practical guidelines to promote this feeding method were proposed. The proposed draft guidelines which promote the use of the flash-heat infant feeding method for HIV-positive mothers in public sector facilities will be communicated to relevant authorities such as the National Department of Health. These guidelines support the new policy shift to exclusive breastfeeding as a child survival strategy in South Africa.Health StudiesD. Litt. et Phil. (Health Studies

Factors influencing HIV-positive mothers to choose to use the flash-heat process of heating breast milk in South Africa

The objective of this cross-sectional study was to establish factors influencing HIV-positive mothers to choose to use the Flash-heat (FH) method to feed milk to new-born babies in South Africa. A total of 70 HIV-positive mothers were selected using purposive sampling methods. Backward stepwise binary logistic regression analysis was carried out to establish their willingness to use the FH feeding method. More than half (54.3%) the mothers were not breastfeeding their infant and among them a third (31.6%) mentioned that breastfeeding was difficult and this was given as the reason for not breastfeeding. Most of the mothers (74.3%) reported that they would use the FH method at home as a feeding method for their infants, and most (83%) of the mothers reported that they were willing to heattreat their expressed breast milk (EBM) in a pot on a Primus stove until the water boils-as required by the FH guideline. The results showed that mothers who reported that they were willing to heat EBM at home were 24 times more likely to adopt FH compared to those who were not willing to heat EBM at home (OR=24.23, p=0.001). Also, those mothers who reported that they were willing to express milk for 4 months had 22 times more chance of adopting FH than mothers who reported that they were not willing to express for 4 months (OR=21.60, p=0.016). The findings suggest that HIV-positive mothers in a public-health facility would adopt flash-heating as an alternative infant-feeding method at home.www.biomedres.infoam2017School of Health Systems and Public Health (SHSPH

Infant feeding practices among HIV-positive mothers at Tembisa hospital, South Africa

Background: Despite the nutritional, physiological and emotional benefits of breastfeeding, HIV-positive mothers cannot practise exclusive breastfeeding for six months because of a range of influences on their feeding choice – thereby creating a caveat for morbidity in infants. Aim: This study explored factors influencing the infant feeding choice of HIV-positive mothers at a peri-urban hospital in Tembisa, South Africa. Methods: This study was qualitative and was conducted among 30 purposefully selected postnatal HIV-positive mothers at Tembisa hospital, Gauteng, from May to June 2011. In-depth interviews were conducted mainly in isiZulu and Sepedi which were then transcribed into English. An open coding system of analysis was used for thematic analysis. Results: Nurses significantly influenced the feeding choices of new mothers – sometimes with inconsistent information. The grandmothers of infants also influenced the new mothers’ feeding options, in some cases with the new mother coming under duress. Other relatives like the sisters and aunts of mothers appeared to significantly affect feeding choices. The time frames expressed for the initiation of a supplementary diet were as follows: before 1 month, at 1 month and at 4 months. The main reason was the belief that infants required more than breast milk as sustenance during this period. Conclusion: In the postnatal hospital setting of this study, the feeding choices of mothers were influenced by nursing personnel. Nursing personnel could marry the influential ‘authority’ they have with correct and consistent information, in order to change feeding behaviour. Significant ‘others’ like grandmothers and other relatives also influenced decisions on infant feeding. As such, family dynamics need to be considered when encouraging breastfeeding