Document Detail

Infant feeding modes and determinants among HIV-1-infected African Women in the Kesho Bora Study.
MedLine Citation:
PMID:  23075919     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess breastfeeding modes and determinants in a prevention of mother-to-child transmission study.
DESIGN: HIV-1-infected pregnant women from 5 sites in Burkina Faso, Kenya, and South Africa were enrolled in the study that comprised 2 prospective cohorts and 1 randomized controlled trial. Women were counseled to either breastfeed exclusively up to 6 months or formula feed from birth.
METHODS: Determinants of breastfeeding initiation and continuation by 3 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: Among 1028, 781 women (76%) initiated breastfeeding and 565 of 995 (56%) were still breastfeeding at 3 months postpartum (30% exclusively, 18% predominantly, and 8% partially). Study site (Durban, Mombasa, and Nairobi compared with Bobo-Dioulasso), CD4 cell count (<200 cells/mm), secondary schooling (compared with none), and emergency cesarean delivery (compared with vaginal delivery) were independently associated with a lower probability of ever breastfeeding. The odds of still breastfeeding by 3 months postpartum (among those breastfeeding by 1 month) were lower in Mombasa, Nairobi, and Somkhele (compared with Bobo-Dioulasso) and among infants with neonatal morbidity [0.60 (0.37-0.976)]. The odds of exclusive breastfeeding (EBF) by 3 months (if EBF by 1 month) were 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 counseling 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; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-02-26     Revised Date:  2014-06-17    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-18     Citation Subset:  IM; X    
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MeSH Terms
Breast Feeding / statistics & numerical data*
Burkina Faso / epidemiology
Cohort Studies
HIV Infections / epidemiology*,  transmission*
HIV-1 / isolation & purification*
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control*
Kenya / epidemiology
Pregnancy Complications, Infectious / epidemiology
Prospective Studies
South Africa / epidemiology
Grant Support
097410//Wellcome Trust

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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