Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study

dc.contributor.advisorMyer, Landon
dc.contributor.authorVan De Venter, Claudine
dc.date.accessioned2020-01-23T12:52:13Z
dc.date.available2020-01-23T12:52:13Z
dc.date.issued2019
dc.date.updated2020-01-22T08:52:32Z
dc.description.abstractIntroduction The 2011 Tshwane declaration of support for breastfeeding in South Africa places strong emphasis on exclusive breastfeeding for HIV-exposed infants, overturning prior policy emphasising formula feeding. Prenatal feeding intentions of HIV-exposed women on antiretroviral therapy were compared to postpartum feeding practices. Factors associated to congruence of infant feeding intentions and subsequent practices were identified. Methods This prospective sub-study is nested within Phase 2 of the MCH-ART study. Five hundred and eighty-four women who consented to participate in Phase 2 (of a 3-phase study) were enrolled. Interviews took place at the Gugulethu Community Health Centre from July 2013 to December 2014 at late 3rd trimester and before seven days postpartum. Factors related with prenatal and postpartum characteristics were analysed to identify associations with congruence between infant feeding intentions and practices. Results The majority (81%) of the cohort had intended to exclusively breastfeed, 16% had intended to exclusively formula feed and 3% had intended to practice mixed feeding. By one week postpartum, 9% of women were exclusively breastfeeding, 2% were exclusively formula feeding and 90% were practicing mixed feeding. Congruence in the exclusive breastfeeding, formula and mixed feeding groups was 7%, 1% and 2% respectively. The risk of congruence in infant feeding intentions and practice was significantly less in women who disclosed their HIV-exposed status to anyone compared to those who chose not to disclose (aRR 0.56, 95% CI:0.37-0.93). Conclusions Although most women intended to exclusively breastfeed, the majority practiced mixed feeding and disclosure affected congruence. This indicates that the model used to advise women about infant feeding even in a study setting was not successful. When advising HIV-exposed expectant mothers, their disclosure status should be asked about and accounted for. The results indicate that despite previous study findings in similar socioeconomic environments, prenatal feeding intentions did not predict postpartum practice.
dc.identifier.apacitationVan De Venter, C. (2019). <i>Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/30797en_ZA
dc.identifier.chicagocitationVan De Venter, Claudine. <i>"Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2019. http://hdl.handle.net/11427/30797en_ZA
dc.identifier.citationVan De Venter, C. 2019. Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/30797en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Van De Venter, Claudine AB - Introduction The 2011 Tshwane declaration of support for breastfeeding in South Africa places strong emphasis on exclusive breastfeeding for HIV-exposed infants, overturning prior policy emphasising formula feeding. Prenatal feeding intentions of HIV-exposed women on antiretroviral therapy were compared to postpartum feeding practices. Factors associated to congruence of infant feeding intentions and subsequent practices were identified. Methods This prospective sub-study is nested within Phase 2 of the MCH-ART study. Five hundred and eighty-four women who consented to participate in Phase 2 (of a 3-phase study) were enrolled. Interviews took place at the Gugulethu Community Health Centre from July 2013 to December 2014 at late 3rd trimester and before seven days postpartum. Factors related with prenatal and postpartum characteristics were analysed to identify associations with congruence between infant feeding intentions and practices. Results The majority (81%) of the cohort had intended to exclusively breastfeed, 16% had intended to exclusively formula feed and 3% had intended to practice mixed feeding. By one week postpartum, 9% of women were exclusively breastfeeding, 2% were exclusively formula feeding and 90% were practicing mixed feeding. Congruence in the exclusive breastfeeding, formula and mixed feeding groups was 7%, 1% and 2% respectively. The risk of congruence in infant feeding intentions and practice was significantly less in women who disclosed their HIV-exposed status to anyone compared to those who chose not to disclose (aRR 0.56, 95% CI:0.37-0.93). Conclusions Although most women intended to exclusively breastfeed, the majority practiced mixed feeding and disclosure affected congruence. This indicates that the model used to advise women about infant feeding even in a study setting was not successful. When advising HIV-exposed expectant mothers, their disclosure status should be asked about and accounted for. The results indicate that despite previous study findings in similar socioeconomic environments, prenatal feeding intentions did not predict postpartum practice. DA - 2019 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PY - 2019 T1 - Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study TI - Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study UR - http://hdl.handle.net/11427/30797 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/30797
dc.identifier.vancouvercitationVan De Venter C. Prenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/30797en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.titlePrenatal feeding intentions versus postpartum feeding practices in HIV-exposed women on anti-retroviral therapy: A cohort study
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPH
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