[pronut-hiv] FW: Feeding indecision

[jcanahuati@care.org]

There are several disturbing statements in this report of research.
1. "Or not breastfeed and accept the cost and stigma associated with
using BMS.."

What about the risk?  I cannot believe that these researchers are not
aware of increased risk for morbidity and mortality from BMS. It makes
me wonder about the messages health workers are giving mothers in the
clinic sites in Lusaka.

2."weaning abruptly" at three months.  I'm somewhat confused at how
healthworkers have translated rapid weaning as "abrupt" weaning.  This
is a very dangerous behavior for the mother, increasing her risk for
mastitis, abcesses, etc.  Having just gone through coaching a mom who
weaned rapidly (three weeks) at 23 months because of expected
chemotherapy for cancer, it is quite clear that "abrupt weaning" is an
even more difficult process and should only be attempted with really
good support.

3. 11% (4) mothers, added salt to cow's milk. This is behavior really
increasing the risk of hypernatremia. 

Although the recommendations for healthworkers may be correct, if
idealistic, it is questionable whether healthworkers can be the support
people for mothers in the community.  It is even questionable whether
they should be.

If I were in the situation described in the research, I would probably have opted for a support group model, where "positive deviant" mothers supported either set of options: the breastfeeding option or the
bottlefeeding option and would support moms to adhere to their chosen option, rather than going for "the middle" which is mixed feeding.

I wonder if the type of healthworker "support" reported here isn't actually increasing risk for HIV for the infants involved, as the "support" is not appropriate.

Best,

Judy

Judy Canahuati
Sr. Technical Advisor for Nutrition
CARE
151 Ellis St., NE
Atlanta, GA 30303
email: jcanahuati@care.org

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