Feeding choices and morbidity and mortality among children born to HIV-1 infected mothers during the first 6 months of life in Bobo-Dioulasso (Burkina Faso)

Abstract

To examine effects of maternal factors on choice of infant feeding method, and to assess the effects of feeding method and other maternal and infant factors on morbidity and mortality a prospective study was conducted within the Kesho Bora study that evaluated antiretroviral therapy impact on mother to child transmission of human immune deficiency virus 1. Mean age for the mothers was 27.55 years (range 18-41 years); 69.3% were homemakers and 41.4% had no formal education. Breastfeeding was chosen by 109 mothers (81.3%) compared to 25 mothers (18.7%) choosing formula feeding. The decision to formula feed was more common among mothers who had disclosed their human immune deficiency virus status to a family member (P = 0.0036) and among women who had attained a relatively high level of education (P = 0.001). Morbidity and mortality were assessed for 138 infants (113 exclusively breastfed and 25 formula fed). There were no statistically significant differences in incidence of diarrhea or upper respiratory infection between the two groups of children (P = 0.7 and P = 0.255, respectively), but formula fed children tended to require more frequent hospital care (P = 0.016). Infant mortality after the age of 6 months was not statistically different in the two groups of children (7% in the exclusive breastfeeding group compared to 12% in the formula fed group, P = 0.42). Premature birth and low birth weight were associated with a significant risk of infant mortality (P = 0.001 and P = 0.007 respectively). Considering the prevailing socio-economic conditions in Bobo-Dioulasso, we conclude that exclusive breastfeeding should be the recommended infant feeding method for most women here.