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Background: Human Immunodeficiency virus (HIV) transmission in a breastfeeding population varies from 20% to 45%. Objective: To evaluate breastfeeding practices and the early basic HIV transmission rate in HIV-exposed children in the Djoungolo health district (prevention of mother-to-child transmission HIV programme). Methods: A cross-sectional survey was conducted, targeting breastfeeding mothers recruited from an observational cohort of HIV-positive pregnant women intending to breastfeed. Routine immunological assessment was carried out for all pregnant HIV-positive women coupled with initiation to highly active anti-retroviral therapy (HAART) in those with CD4 cell counts below 350 mm −3 . Early virological diagnosis of HIV infection was done using real-time Polymerase Chain reaction (PCR) RNA for infants aged between 6 weeks and 6 months. Breastfeeding intervention and counselling support were also provided to respondents. Results: Out of 545 women, 287 births were registered of which 64 of the HIV-infected mothers opted for breastfeeding. The mean CD4 cell count was 446 mm −3 ; 34.4% of women were taking HAART. The rate of initiation to breastfeeding was observed to be 53% within 1 h following delivery. At 13 weeks, 96.1% were still exclusively breastfeeding on demand with an average of six feedings in the daytime and three feedings during the night. Of the mothers, 18.5% reported at least one episode of breast and/or nipple pain and 4.9% of mothers were practicing mixed feeding. The early rate of HIV transmission among 47 infants assessed was observed to be 4.3% [95% confidence interval 1–10.1]. Conclusion: In an HIV context, routine breastfeeding intervention support associated with access to anti-retroviral therapy for women yet requiring treatment for themselves reduces the practice of mixed feeding and slashes the early mother-to-child HIV transmission rate to 4.3% in breastfeeding populations.

journal of tropical pediatrics

Preliminary assessment of breastfeeding practices in HIV 1-infected mothers (prior to weaning) under the Djoungolo programme on the prevention of mother-to-child transmission of HIV