Influence of HIV on the onset of lactation among Ghanaian women

In Ghana, breastfeeding is the most economically feasible and culturally acceptable method of infant feeding. HIV positive mothers are advised to exclusively breastfeed for 6 months and to stop as soon as it is feasible and safe. Knowing when to expect milk production to increase is important especially in counseling HIV positive women who intend to exclusively breastfeed, to prevent the introduction of other foods which would affect exclusive breastfeeding (EBF) duration. ^ This was a longitudinal cohort study, with quantitative and qualitative components, investigating the association between maternal HIV status and the reported onset of lactation (OL), specifically: (1) to validate the reported maternal perception of the OL based on longitudinal infant weight measurements and test weights of infant breastmilk intakes, (2) to determine the influence of HIV on the OL, (3) to assess the influence of HIV status on breast health during the first month postpartum, (4) to determine the influence of HIV on EBF during the first 3 months postpartum and (5) to determine the barriers to as well as the benefits and predictors of EBF. ^ Participants were 425 mothers participating in the Research to Improve Infant Nutrition and Growth (RIING) project recruited from three antenatal clinics in the Eastern region of Ghana, based on HIV status. OL was assessed by maternal perception which was validated using sub-samples for infant test weight measurements (n = 40) and daily infant weight measurements for 2 weeks postpartum (n = 150). Multivariate logistic regression was used to identify predictors of very early onset of lactation (VEOL; OL \u3c 6 hours). Predictors of VEOL included: HIV-status (OR=2.68; p=0.014), multiparity (OR=2.93; p=0.009), vaginal delivery (OR=2.55; p=0.035) and having a male child (OR=1.86; p=0.032). ^ The qualitative study shows widespread EBF knowledge in this population with antenatal clinics being the major source of infant feeding information. The health and well-being of the infant were identified as the main motivation for EBF, while perceived breastmilk unavailability, employment and pressure from family were the major barriers to EBF. ^ Our findings indicate an association between maternal HIV status and VEOL.

Influence of HIV on the onset of lactation among Ghanaian women

In Ghana, breastfeeding is the most economically feasible and culturally acceptable method of infant feeding. HIV positive mothers are advised to exclusively breastfeed for 6 months and to stop as soon as it is feasible and safe. Knowing when to expect milk production to increase is important especially in counseling HIV positive women who intend to exclusively breastfeed, to prevent the introduction of other foods which would affect exclusive breastfeeding (EBF) duration. ^ This was a longitudinal cohort study, with quantitative and qualitative components, investigating the association between maternal HIV status and the reported onset of lactation (OL), specifically: (1) to validate the reported maternal perception of the OL based on longitudinal infant weight measurements and test weights of infant breastmilk intakes, (2) to determine the influence of HIV on the OL, (3) to assess the influence of HIV status on breast health during the first month postpartum, (4) to determine the influence of HIV on EBF during the first 3 months postpartum and (5) to determine the barriers to as well as the benefits and predictors of EBF. ^ Participants were 425 mothers participating in the Research to Improve Infant Nutrition and Growth (RIING) project recruited from three antenatal clinics in the Eastern region of Ghana, based on HIV status. OL was assessed by maternal perception which was validated using sub-samples for infant test weight measurements (n = 40) and daily infant weight measurements for 2 weeks postpartum (n = 150). Multivariate logistic regression was used to identify predictors of very early onset of lactation (VEOL; OL \u3c 6 hours). Predictors of VEOL included: HIV-status (OR=2.68; p=0.014), multiparity (OR=2.93; p=0.009), vaginal delivery (OR=2.55; p=0.035) and having a male child (OR=1.86; p=0.032). ^ The qualitative study shows widespread EBF knowledge in this population with antenatal clinics being the major source of infant feeding information. The health and well-being of the infant were identified as the main motivation for EBF, while perceived breastmilk unavailability, employment and pressure from family were the major barriers to EBF. ^ Our findings indicate an association between maternal HIV status and VEOL.

Department of Nutrition and Food Science, School of Biological Sciences, University of Ghana, Accra, Ghana problem

Introduction: In a society where 'plumpness' is traditionally favoured, it is imperative to examine the impact of sociocultural factors on the rising overweight/obesity problem. The study was designed to assess the preferred body size among women in Kumasi metropolis, Ghana. Methods: A cross-sectional survey was conducted among 394 women, aged 20 years and above, in 6 randomly selected churches in the Kumasi metropolis. Subjects were asked to select their preferred body size from photographic silhouettes consisting of six images of women of known BMI (20, 24, 28, 30, 33 and 38kg/m2) arranged in random order. Participants were asked to associate items concerning body size preference, health, social and individual attributes to one of the six silhouettes. Participants' BMI were assessed. Independent samples t-test and analysis of variance were used to assess differences in preferred body size across categories of BMI and socio-demographic characteristics. Results: The prevalence of overweight/obesity among the women was 68.4%. The respondents preferred a large (overweight) body size. They associated silhouette of large (overweight) body size with eating well, affluence and high social value. Though the overweight/obese respondents associated normal body size with health they preferred a large (overweight) body size. Conclusion: Sociocultural ideals for body size override health reasons for the women's preferred body size. This study shows that tackling the overweight/obesity problem solely from nutrition and health perspective may not be adequate. A holistic interdisciplinary strategy involving nutrition, health, social and behavioural science is needed to develop culturally-sensitive interventions against the emerging obesity problem.Pan African Medical Journal 2016; 2