Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi

被引：24

作者：

Piwoz E.G. ^{[1
]}

Ferguson Y.O. ^{[2
]}

Bentley M.E. ^{[2
]}

Corneli A.L. ^{[2
]}

Moses A. ^{[3
]}

Nkhoma J. ^{[3
]}

Tohill B.C. ^{[4
]}

Mtimuni B. ^{[5
]}

Ahmed Y. ^{[4
]}

Jamieson D.J. ^{[4
]}

van der Horst C. ^{[2
]}

Kazembe P. ^{[6
]}

Adair L.

Albrecth S.

Alt-Khaled M.

Bangdiwala K.

Bayer R.

Butera S.

Chigwenembe J.

Chilongozi D.

Chiudzu G.

Cole A.

Corbett A.

Duerr A.

Eliya H.

Fiscuss S.

Galvin S.

Heilig C.

Hoffman I.

Hooten E.

Hsiao T.

Hurst S.

Joaki G.

Jones D.

Kamanga G.

Kamthunzi P.

Kanyama C.

Kashuba A.

Kathyola D.

Knight R.

Krysiak R.

Loeliger E.

Luhanga M.

Maida A.

Martinson F.

Mayers D.

Mayuni I.

McDonough M.

Merry C.

Msungama W.

机构：

[1] Academy for Educational Development, Washington, DC 20009

[2] University of North Carolina at Chapel Hill, Chapel Hill, NC 27514

[3] UNC Project, Lilongwe

[4] US Centers for Disease Control and Prevention, Atlanta, GA 30333

[5] Bunda College of Agriculture, Bunda

[6] Kamuzu Central Hospital, Lilongwe

来源：

International Breastfeeding Journal | / 1卷 / 1期

关键词：

Breast Milk; Exclusive Breastfeed; Infant Feeding; Breast Health; Infant Feeding Practice;

D O I：

10.1186/1746-4358-1-2

中图分类号：

学科分类号：

摘要：

Background: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. Methods: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. Results: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. Conclusion: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions. © 2006 Piwoz et al; licensee BioMed Central Ltd.

引用

共 38 条

[1]

AIDS Epidemic Update: 2004UNAIDS/WHOAIDS Epidemic Update: 2004, (2004)

[2]

New data on the prevention of mother-to-child transmission of HIV and their policy implications: Conclusions and recommendations, (2001)

[3]

Global strategy for infant and young child feedingWHO/UNICEFGlobal strategy for infant and young child feeding Geneva, (2003)

[4]

Infant and Young Child Nutrition Policy and Guidelines, (2003)

[5]

Ahmed F., Clemens J.D., Rao M.R., Sack D.A., Khan M.R., Haque E., Community-based evaluation of the effect of breast-feeding on the risk of microbiologically confirmed or clinically presumptive shigellosis in Bangladeshi children, Pediatrics, 90, pp. 406-411, (1992)

[6]

Brown K.H., Black R.E., Lopez de Romana G., Creed de Kanashiro H., Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru, Pediatrics, 83, pp. 31-40, (1989)

[7]

Victora C.G., Smith P.G., Vaughan J.P., Nobre L.C., Lombardi C., Teixeira A.M., Fuchs S.M., Moreira L.B., Gigante L.P., Barros F.C., Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil, Lancet, 2, pp. 319-322, (1987)

[8]

Coutsoudis A., Pillay K., Spooner E., Kuhn L., Coovadia H.M., Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: A prospective cohort study, Lancet, 354, pp. 471-476, (1999)

[9]

Iliff P.J., Piwoz E.G., Tavengwa N.V., Zunguza C.D., Marinda E.T., Nathoo K.J., Moulton L.H., Ward B.J., Humphrey J.H., Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival, AIDS, 19, pp. 699-708, (2005)

[10]

Kourtis A.P., Butera S., Ibegbu C., Beled L., Duerr A., Breast milk and HIV-1: Vector of transmission or vehicle of protection?, Lancet Infect Dis, 12, pp. 786-793, (2003)

← 1 2 3 4 →