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Early Breastfeeding Cessation Among HIV-Infected and HIV-Uninfected Women in Western Cape Province, South Africa

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Abstract

As part of the Mother-Infant Health Study, we describe infant feeding practices among HIV-infected and HIV-uninfected mothers over a 12-month period when the Western Cape Province prevention of mother-to-child transmission (PMTCT) program was transitioning from a policy of exclusive formula feeding to one of exclusive breastfeeding. Two hundred pairs of mother and HIV-uninfected infant were included in the analysis, among whom 81 women were HIV uninfected and breastfeeding. Of the 119 HIV-infected mothers, 50 (42%) were breastfeeding and 69 (58%) were formula feeding. HIV-infected mothers predominantly breastfed for 8.14 (7.71–15.86) weeks; HIV-uninfected mothers predominantly breastfed for 8.29 (8.0–16.0) weeks; and HIV-infected mothers predominantly formula fed for 50.29 (36.43–51.43) weeks. A woman’s HIV status had no influence on the time to stopping predominant breastfeeding (P = 0.20). Our findings suggest suboptimal duration of breastfeeding among both HIV-infected and HIV-uninfected mothers. Providing support for all mothers postdelivery, regardless of their HIV status, may improve breastfeeding practices.

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Acknowledgements

This work was supported in part by the Major Thematic Grant from the Peter Wall Institute for Advanced Studies, University of British Columbia (F0906208) and the Canadian Institutes of Health Research Canada-HOPE Scholarship Program (Grant Number CH1-106949); The United States President’s Emergency Plan for AIDS Relief (PEPFAR) through HRSA under the terms of T84HA21652; Stellenbosch University Faculty of Medicine and Health Sciences Clinical Research Grant; South Africa Medical Research Council Self-Initiated Grant; Harry Crossley Foundation Project Funding; and Stellenbosch University Temporary Research Assistant Grant. We wish to acknowledge the support and training Dr Moleen Zunza received from the University of California, San Francisco, International Traineeships in AIDS Prevention Studies (ITAPS), US NIMH, R25 MH064712. Dr Amy Slogrove was supported by research fellowships from the Canadian Institutes of Health Research Canada-HOPE Scholarship Program, the Canadian HIV Trials Network International Fellowship, and the South African National Health Scholarship Programme. Dr Julie Bettinger is a Michael Smith Foundation for Health Research scholar. We thank the mothers and infants who generously donated their time to the MIHS study and without whose participation the study would not have been possible. We gratefully acknowledge the expert assistance provided by the staff at Family Clinical Research Unit, Tygerberg Academic Hospital, Stellenbosch University, Cape Town, South Africa; and the Vaccine Evaluation Center, BC Children’s Hospital, University of British Columbia, Vancouver, Canada. We thank Dr Krysia Lindan for her mentorship during the drafting of the manuscript. The funders had no role in the study design, data collection and analysis, preparation of the manuscript, or decision to submit the manuscript for publication. Mother-Infant Health Study Project Steering Committee: David Speert, University of British Columbia, Vancouver, Canada. Monika Esser, Stellenbosch University, Cape Town, South Africa. Julie A. Bettinger, University of British Columbia, Vancouver, Canada. Mark F. Cotton, Stellenbosch University, Cape Town, South Africa.

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Authors and Affiliations

  1. Department of Paediatrics & Child Health, Stellenbosch University, Francie van Zijl Drive, Cape Town, 8000, South Africa

    Moleen Zunza, Amy Slogrove & Mark F. Cotton

  2. Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa

    Moleen Zunza

  3. Department of Pathology, Immunology Unit, National Health Laboratory Service, Stellenbosch University, Cape Town, South Africa

    Monika Esser

  4. School of Population & Public Health, University of British Columbia, Vancouver, Canada

    Amy Slogrove

  5. Vaccine Evaluation Center, BC Children’s Hospital, University of British Columbia, Vancouver, Canada

    Julie A. Bettinger

  6. Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA

    Rhoderick Machekano

Authors
  1. Moleen Zunza
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  2. Monika Esser
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  3. Amy Slogrove
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  4. Julie A. Bettinger
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  6. Mark F. Cotton
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Consortia

the Mother-Infant Health Study (MIHS) Project Steering Committee

  • David Speert
  • , Monika Esser
  • , Julie A. Bettinger
  •  & Mark F. Cotton

Corresponding author

Correspondence to Moleen Zunza.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants in the study.

Additional information

The authors in Mother-Infant Health Study Project Steering Committee are listed in acknowledgement section.

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Zunza, M., Esser, M., Slogrove, A. et al. Early Breastfeeding Cessation Among HIV-Infected and HIV-Uninfected Women in Western Cape Province, South Africa. AIDS Behav 22 (Suppl 1), 114–120 (2018). https://doi.org/10.1007/s10461-018-2208-0

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  • DOI: https://doi.org/10.1007/s10461-018-2208-0

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