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The feasibility of replacement feeding as an HIV prevention method in Lilongwe, Malawi: Results of the BAN Study
Author(s) -
Parker Megan E,
Bentley Margaret E,
Adair Linda,
Jamieson Denise,
Ellingston Sascha,
Chasela Charles,
Mkhomawanthu Chimwemwe,
Tembo Martin,
Martinson Francis,
Horst Charles
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.94.6
Subject(s) - breastfeeding , medicine , weaning , human immunodeficiency virus (hiv) , micronutrient , breast feeding , population , environmental health , pediatrics , child health , breast milk , family medicine , biochemistry , chemistry , pathology , endocrinology
International guidelines recommend exclusive breastfeeding (EBF) to 6 months among HIV‐infected mothers choosing to breastfeed, with cessation of BF once replacement feeding is acceptable, feasible, affordable, sustainable and safe. When mothers wean, they are challenged to provide an adequate replacement diet. This study investigates use and acceptability of a peanut‐based ready‐to‐use, micronutrient‐enriched paste (RUF) as a breastmilk substitute when provided to 6–12 mo. old infants of HIV+ mothers, as part of the BAN (Breastfeeding, Antiretroviral, and Nutrition) Study. A sub‐sample of mothers (n=45) was interviewed when their child was 15–16 mo. old. Quantitative and qualitative analyses explored issues related to weaning strategies using RUF from 6 to12 mo. and challenges faced when RUF was no longer provided at 12 mo. Mothers reported 8 strategies used for cessation of BF at 6–7 months including gradual reduction of BF episodes, expressing breastmilk into a cup, and using alternate caregivers. RUF was well accepted by mothers and infants (98%) and incorporated into the traditional infant diet. When RUF was no longer provided, infants stopped accepting the staple maize porridge, particularly among food insecure households. Early BF cessation is a feasible HIV prevention method among this low‐income population in Malawi when supported by the provision of RUF as a breast milk substitute. Grant Funding Source : CDC and the National Institutes of Health, National Institute of Child Health and Human Development (NICHD, 1R03HD057775‐01)