The acceptance and feasibility of replacement feeding at 6 months as an HIV prevention method in Lilongwe, Malawi: results from the BAN study
Parker, M.E.; Bentley, M.E.; Chasela, C.; Adair, L.; Piwoz, E.G.; Jamieson, D.J.; Ellington, S.; Kayira, D.; Soko, A.; Mkhomawanthu, C.; Tembo, M.; Martinson, F.; Van der Horst, C.M.
Aids Education and Prevention Official Publication of the International Society for Aids Education 23(3): 281-295
2011
ISSN/ISBN: 0899-9546 PMID: 21696245 DOI: 10.1521/aeap.2011.23.3.281Document Number: 218809
International guidelines recommend EBF to age 6 months among HIV-infected mothers choosing to breast-feed and cessation thereafter if replacement feeding is acceptable, feasible, affordable, sustainable, and safe. When mothers wean, they are challenged to provide an adequate replacement diet. This study investigates the use and acceptability of a lipid-based nutrient supplement (LNS) as a breast-milk substitute when provided to infants (6-12 mo) of HIV-positive mothers, as part of the Breast-feeding, Antiretroviral, and Nutrition (BAN) Study. A sub-sample of mothers (n = 45) participated in interviews that explored EBF, weaning, and strategies to feed LNS. Mothers reported several weaning strategies, including gradual reduction of breast-feeding, expressing breast-milk into a cup, and separation of mother and child. LNS, a peanut-based micronutrient fortified paste, was highly accepted and incorporated into the traditional diet. Weaning is a feasible HIV prevention method among this population in Malawi when supported by the provision of LNS as a breast-milk substitute.