Feeding practices and nutritional status of HIV-exposed and HIV-unexposed infants in the Western Cape
Date
2016-05-13
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS Publishing
Abstract
Background: Optimal infant- and young child–feeding practices are crucial for nutritional
status, growth, development, health and, ultimately, survival. Human breast milk is optimal
nutrition for all infants. Complementary food introduced at the correct age is part of optimal
feeding practices. In South Africa, widespread access to antiretrovirals and a programme to
prevent mother-to-child transmission of HIV have reduced HIV infection in infants and
increased the number of HIV-exposed uninfected (HEU) infants. However, little is known
about the feeding practices and nutritional status of HEU and HIV-unexposed (HU) infants.
Objective: To assess the feeding practices and nutritional status of HIV-exposed and
HIV-unexposed (HU) infants in the Western Cape.
Design: Prospective substudy on feeding practices nested in a pilot study investigating
the innate immune abnormalities in HEU infants compared to HU infants. The main study
commenced at week 2 of life with the nutrition component added from 6 months. Information
on children’s dietary intake was obtained at each visit from the caregiver, mainly the mother.
Head circumference, weight and length were recorded at each visit. Data were obtained
from 6-, 12- and 18-month visits. World Health Organization feeding practice indicators and
nutrition indicators were utilised.
Setting: Tygerberg Academic Hospital, Western Cape. Mothers were recruited from the
postnatal wards.
Subjects: Forty-seven mother–infant pairs, 25 HEU and 22 HU infants, participated in this
nutritional substudy. Eight (17%) infants, one HU and seven HEU, were lost to follow-up over
the next 12 months. The HEU children were mainly Xhosa (76%) and HU were mainly mixed
race (77%).
Results: The participants were from poor socio-economic backgrounds. In both groups,
adherence to breastfeeding recommendations was low with suboptimal dietary diversity. We
noted a high rate of sugar- and salt-containing snacks given from a young age. The HU group
had poorer anthropometric and nutritional indicators not explained by nutritional factors
alone. However, alcohol and tobacco use was much higher amongst the HU mothers.
Conclusion: Adherence to breastfeeding recommendations was low. Ethnicity and cultural
milieu may have influenced feeding choices and growth. Further research is needed to
understand possible reasons for the poorer nutritional and anthropometric indicators in the
HU group.
Description
CITATION: Rossouw, M. E., Cornell, M., Cotton, M. F. & Esser, M. M. 2016. Feeding practices and nutritional status of HIV-exposed and HIV-unexposed infants in the Western Cape. Southern African Journal of HIV Medicine, 17(1), a398, doi:10.4102/sajhivmed.v17i1.398.
The original publication is available at http://www.sajhivmed.org.za
The original publication is available at http://www.sajhivmed.org.za
Keywords
HIV exposed infants, Infants -- Nutrition -- South Africa, Infant feeding practices
Citation
Rossouw, M. E., Cornell, M., Cotton, M. F. & Esser, M. M. 2016. Feeding practices and nutritional status of HIV-exposed and HIV-unexposed infants in the Western Cape. Southern African Journal of HIV Medicine, 17(1), a398, doi:10.4102/sajhivmed.v17i1.398.