Infant Feeding Practices of Women in a Perinatal HIV-1 Prevention Study in Nairobi, Kenya

Abstract

Objective: To determine feeding practices and nutritional status of infantsborntoHIV-1–infectedwomen. Methods: Feeding plans and practices were evaluated by questionnaires and focus group discussions. Infants were weighed at 1 and 6 weeksandtestedforHIV-1at6weeks. Results: Of 128 women seen after delivery, 111 completed the study. Mothers who planned to breast feed were more likely to feed their infants as planned (86% vs. 55%; P < 0.001). Women opted to breastfeedduetofinancialconstraints,partnerinfluence,andfearof losing confidentiality. Women who reported that their partners were willingtohaveHIV-1testingwerelesslikelytobebreastfeedingat6 weeks(oddsratio[OR]=0.3,95%confidenceinterval[CI]:0.1–0.8; P=0.01).At6weeks,moreinfantsweremixedfed(31%vs.21%;P= 0.05)thanat1week.Lowerinfantweightat6weekswasassociatedwith notbreastfeeding(P=0.001),HIV-1infection(P=0.05),birthweight <3000g(P=0.01),maternalemployment(P=0.02),andpaying<$12.5 permonthinhouserent(amonginfantsnotbreastfed;P=0.05). Conclusions:Replacementfeedingwasdifficult,particularlywithout partner support in HIV-1 testing. Mixed feeding was common and increasedby6weeks.Mothersoflowsocioeconomicstatuswhooptnotto breastfeedrequiresupporttoavoidnutritionalcompromiseof