Factors affecting mothers' choice of infant feeding method / S. Schoonwinkel.
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The benefits of breastfeeding are well known. It has been shown that HIV is transmitted through breast milk. The HIV epidemic is threatening exclusive breastfeeding in South Africa. It is important that mothers make the right infant feeding choice. There are three basic infant feeding methods available for HIV infected mothers namely; breastfeeding, replacement feeding or formula feeding and heat treatment of breast milk. There are many risk factors for the transmission of HIV through breast milk. Exclusive breastfeeding may reduce the risk of mother-to-child-transmission, compared with mixed feeding. This can only take place when breastfeeding is done safely and not mixed with other food or drinks. There are many factors that influence a mother's decision to breastfeed, for example personal, social, cultural factors, facilities, environmental factors, knowledge about breastfeeding, mass media and friends. There are also many sources of information about infant feeding methods. The aim of this study was to determine which factors influence the decision on the early infant feeding choice of women who delivered at the Lower Umfolozi District War Memorial Hospital in Empangeni, KwaZulu-Natal. This may help to understand what factors health professionals should focus on in promoting appropriate infant feeding methods. A structured questionnaire was completed by a 100 women and focus group discussions were held with 22 women who delivered at the Lower Umfolozi District War Memorial Hospital. Most of the mothers (72%) did choose breastfeeding, and 58% of these mothers intended to breastfeed for only six months. The majority of the women (97%) received counseling about their infant feeding method, mostly from a health care worker at the clinic. One-third of the women (33%) were influenced by health care professionals on deciding on their infant feeding method and 44% of the participants indicated that no-one influenced them and that they decided themselves. In the focus group discussions the fear of transmission of HIV through breast milk was stated as an important reason why mothers should choose replacement feeding. In conclusion the most important results are that significantly more HIV-infected mothers chose replacement feeding as infant feeding method, and mothers who chose breastfeeding were significantly older than mothers who selected replacement feeding and they made their infant feeding decision significantly earlier than those who chose replacement feeding. According to the focus group discussion results the communities also felt that the HIV-infected mothers should not breastfeed their infants due to the fact that the virus can be transmitted through breast milk. Health professionals should still provide all the necessary information about exclusive breastfeeding for the first six months, even where the prevalence of HIV is high. In most of these areas replacement feeding will not be acceptable, feasible, affordable, sustainable and safe, due to lack of safe water, sanitation and the poor socio-economic status of these people. The dangers of mixed feeding should be emphasized. Most of the women in this study received information from health care workers and family. It is important that family members are included when information is given to women of child-bearing age. Health care workers need appropriate training to ensure that they give the right messages about safe infant feeding to the mothers.
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