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Infant feeding modes and determinants among HIV-1-infected African women in the Kesho Bora study.
MedLine Citation:
PMID:  23075919     Owner:  NLM     Status:  Publisher    
OBJECTIVE:: To assess breastfeeding modes and determinants in a prevention of mother-to-child-transmission (MTCT) study. DESIGN:: HIV-1-infected pregnant women from five sites in Burkina Faso, Kenya and South Africa were enrolled in the study which comprised two prospective cohorts and one randomized controlled trial. Women were counselled to either breastfeed exclusively up to six months or formula-feed from birth. METHODS:: Determinants of breastfeeding initiation and continuation by three months postpartum were investigated using multiple logistic regression analysis. Neonatal morbidity was defined as mother-reported fever, diarrhea, or vomiting during the first month of life. RESULTS:: 781/1028 women (76%) initiated breastfeeding and 565/995 (56%) were still breastfeeding at three months postpartum (30% exclusively, 18% predominantly and 8% partially). Study site (Durban, Mombasa and Nairobi compared to Bobo-Dioulasso), CD4 cell count (<200 cells/mm), secondary schooling (compared to none), and emergency Cesarean section (compared to vaginal delivery) were independently associated with a lower probability of ever breastfeeding. The odds of still breastfeeding by three months postpartum (among those breastfeeding by one month) was lower in Mombasa, Nairobi and Somkhele (compared to Bobo-Dioulasso) and among infants with neonatal morbidity [0.60 (0.37-0.976)]. The odds of exclusive breastfeeding (EBF) by three months (if EBF by one month) was lower in Mombasa and Nairobi, in ill neonates [0.54 (0.31-0.93)] and boys [0.51 (0.34-0.77)]. CONCLUSIONS:: EBF was of short duration, particularly for boys. The importance of neonatal morbidity for breastfeeding cessation requires further investigation. Infant feeding counselling might need adaptation to better support mothers of boys and ill neonates.
Kirsten Bork; Cécile Cames; Amandine Cournil; Faith Musyoka; Kossiwavi Ayassou; Kevindra Naidu; Stephen Mepham; Christine Gichuhi; Jennifer S Read; Philippe Gaillard; Isabelle de Vincenzi;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-15
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  -     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Members of the Kesho Bora Study Group are listed in the Appendix. 1Institut de Recherche pour le Développement (IRD), UMI233 IRD/UM1, Montpellier, France 2International Centre for Reproductive Health (ICRH), Mombasa, Kenya 3Centre Muraz, Bobo-Dioulasso, Burkina Faso 4Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa 5University of KwaZulu-Natal, Durban, South African Republic 6Africa Hospital, Nairobi, Kenya 7Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA (current affiliation: NVPO/OASH/OS/DHHS¸ Washington, DC, USA) 8WHO, Reproductive Health and Research, Geneva, Switzerland (affiliation at the time of the study).
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