Horizons | Research Summary| Infant Feeding Counseling Within Kenyan and Zambian PMTCT Services: How Well Does It Promote Good Feeding Practices?

RESEARCH SUMMARY

December 2003

Infant Feeding Counseling Within Kenyan and Zambian PMTCT Services: How Well Does It Promote Good Feeding Practices?

Box: HIV and Infant Feeding Intervention Strengthens Exclusive Breastfeeding Rates

In May 2000, a package of PMTCT services was introduced into routine antenatal and postnatal consultations at six MCH clinics in Ndola, Zambia, with a particular focus on infant feeding guidance and VCT. (No antiretrovirals were available at this time.) All pregnant women and mothers attending routine clinic consultations received context-specific infant feeding information based on local assessments. A counselor guided each woman through the choices, encouraging her to evaluate the relative risks and benefits of each feeding option. A Horizons-led research team measured changes in knowledge, attitudes, and practices about infant feeding and other topics among samples of pregnant women and mothers of young children.

By the end of the study period, more women became aware that HIV can be transmitted during breastfeeding, and most knew that they could reduce the risk through early weaning or replacement feeding. Yet, contrary to concerns that discussing HIV risk might erode good breastfeeding practice, most women reported following program guidelines in choosing to exclusively breastfeed, even though more than 85 percent had not been tested. Following the intervention, the percentage of mothers of unknown HIV status with infants six months old or younger reporting that they were exclusively breastfeeding rose from 57 percent to 70 percent, and fewer mothers reported mixed feeding. More than 70 percent of health workers interviewed said that they felt technically competent to provide infant feeding counseling, and observations confirmed that they were increasingly integrating infant feeding counseling into ANC/MCH sessions.

The study showed that the program's conscientious reinforcement of a long history of breastfeeding promotion in Ndola, including community-based education and mobilization, helped to increase exclusive breastfeeding rates even further. Another important factor was the intensive and ongoing training of clinic- and community-based health workers, combined with information provided to mothers about PMTCT and infant feeding.

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