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Episode 7 - Feeding for HIV positive Mothers

Parenthood can be daunting. And with so many differing opinions out there, trying to make the right decisions for your children is sometimes confusing. This is especially true for HIV positive mothers who are trying to protect their children from contracting the disease. This week on Siyayinqoba Beat It! one of the most complicated HIV-related topics is discussed: feeding and HIV. There is not one correct or incorrect way for HIV positive mothers to feed their babies; we examine the various options open to women and underline the importance of mothers getting the appropriate information before making a decision one way or another.

Shalom Ncala: Ngiyanibingelela ngiyanamkela ehlelweni i-Siyayinqoba Beat It! Kulo luhlelo asifihli ukuthi siphila negciwane lengculaza ngakho samkela bonke ozakwethu abangane, abalingane bazonqoba ingculaza nathi. Namhlanje sizoxhoxa ngomama abancelisayo abaphila nengciwane lengculaza. Samkela nethimba elikhuthazayo. Ngoba eli ngciwane lingatholakala ngokuncelisa ngakho kumqokwa kakhulu udaba lokuthi uncelisa kanjani ukuba umama unaneli gciwane. Namhlanje sino Doctor Diane Gray oqhambuka e Groote Schuur Hospital.[IsiZulu] Hello and welcome to Siyayinqoba Beat It! On this programme we are all living openly and positively with HIV. And we welcome all our partners families and friends to beat HIV with us. Today we are talking about infant feeding for mothers who are living with HIV. Welcome to the support group. Because HIV can be carried in the breast milk, the issue of how a mother living with HIV feeds her baby is of great importance. Today we have Dr Diane Gray from Groote Schuur Hospital.

Shalom:Welcome Doctor

Dr Diane Grey: Hello Shalom

Shalom: How are you today ?

Dr Diane: I am fine thank you

Shalom: Udaba lwethu lokuqala olwase Mdantsane eMpumalanga Koloni. Akhesibheke lolu daba. [isiZulu] Our first story is from Mdantsane in the Eastern Cape. Let's go and check it out!

Amanda Funani: eMzamtsi Afrika omama bayakhethiswa phakathi kokuncancisa ibele okanye ubisi oluthengwayo. Kodwa leyo bayi kethileyo kumele bayisebenzise yodwa bangayi xhubi nanto. Isebe lezempilo likhuthaza ukuncancisa ibele inyanga ezintandathu. U-Siyayinqoba udibene noZukiswa Currie othe wancancisa umntwana wakhe iinyanga ezilishumi elinanye. Lento ayikhuthazwa ngoba ukuba uqhubeka nokuncancisa emveni kokunikeza umntwana ukutya nokuba nga manzi ubeka umntwana elunciphekweni wokusuleleka yintsolongwane kagawulayo. Masive ibali lika Zukiswa. [IsiXhosa] In South Africa , mothers are given the choice of either exclusively breastfeeding or exclusively formula feeding for their babies. Our health department has been strongly advising exclusive breastfeeding for a period of six months. Siyayinqoba met Zukiswa Currie who has been breastfeeding 11 months. This is not recommended because if you continue to breastfeed after giving the child other food or even water, you risk infecting your baby with HIV. Let's hear Zukiswa's story.

Amanda: Kwakutheni uze uchoose uku breadfeeder endaweni yokuba usebenzise ibotile. Ingaba ifemeli yakho yakunyanzela ukuba ubreadfeeder? [IsiXhosa] Why did you choose breastfeeding instead of bottle feeding? Did your family force you to breastfeed?

Zukiswa Currie: Ndandiza kwala ne ukubana andizo kummncancisa ndizakusebenzisa olu bisi. Babuze ukubana kuloo wokuqala wawumncancisile kutheni kulona wesibini ungafuni ukuncancisa uyaqonda. So ndandibaleka lonto andikwazi ukuxoka isidala. Kuyakufuneka ndichaze inyani ukuba hayi kwenzeka njena nanjena. Uyaqonda ndi positive ngoluhlobo. So ke ngoku ndaqonda masendi mncancisa kuba amabele am ayavuza. Kufuneka ndincancisile. [IsiXhosa] I was not going to breastfeed, I was going to use milk. The they asked why I'm not breastfeeding this child, like I breastfed the first one. So I was trying to hide the truth but knew that I wouldn't be able to lie for much longer. I knew I would have to tell them the truth, that I'm HIV positive. So I decided to breastfeed because I had breast milk and they told me to.

Amanda: Ikhona enye into ayityayo ngaphandle kwebele? [IsiXhosa] Does he eat anything else except milk?

Zukiswa: Uyakutya ukutya akukho nto angayi tyiyo into angayi funiyo lubisi nolunjani ufuna ukuncanca qa. [IsiXhosa] He does eat food, but he doesn't want anything other milk except for breast milk.

Amanda: Lona wokuqala umntwana wawumncancisile? [IsiXhosa] Did you breastfeed your first child as well?

Zukiswa: Ewe ndandimcancisile nalowo kuqala ndiyekise ukumncancisa ene 8 months Ndayeka ukumncancisa. [IsiXhosa] Yes I did, but I stopped breastfeeding at 8 months.

Amanda: Wake waya wayoba testa bobayi 2 ukuba esabo istatus sithini? [IsiXhosa] Did you have them tested for HIV?

Zukiswa: Bendim testile lowokuqala umntwana unegative. Lo wesbini ndizakum testa xa enonyaka akakabinayo umnyaka. [IsiXhosa] I tested the first child and the result was negative. The second one will test after he is one year old.

Amanda: And then wena wa feelisha kanjani ngokuncancisa ekubeni ubungafuni ukumncancisa umntwana?[IsiXhosa] How did you feel about being pushed to breastfeed when you didn't want to in the first place?

Zukiswa: Yayibuhlungu intliziyo yam but yayingekho buhlungu kakhulu kuba lo wokuqala ?ndandimcancisile ndathi xa ndiyokumtesta ndafumanisa ukuba unegative. Ndzixelela ukuba lona mandimcancise naye. [IsiXhosa] I was heart broken, but not that much because with my first child I tested after breastfeeding and the baby tested HIV negative. That is why I decided to breastfeed this one as well.

Amanda: Wena yeyiphi eyixhasayo uku breadfeeder okanye uku bottle feeder? [IsiXhosa] So which would you encourage the most, breastfeeding or bottled milk?

Zukiswa: Umntu makancancise ibenye ibele okanye okanye ibhotile angazixhubi zombini umntu opositive [IsiXhosa] HIV positive mother must choose one, either the breast milk or bottled milk, but not mix both.

Shalom: Doctor am a bit disturbed about what I saw in the insert. Things like that really do happen in rural settings as well as urban settings as well. But I just want you to explain to us why do we necessarily say to woman that they must exclusively breastfeed or give the baby a bottle.

Dr Diana: We know that breastfeeding is the best type of feeding in infants. Normally it keeps them healthier, protects them from infections and we know that babies who are not breastfeed have a higher risk of getting chest infections and diarrhea disease and in areas where those infections are common actually there is a high chance of dying if there are not breastfeed. So breastfeeding as an advantage but with HIV infections there is the risk that you may pass the HIV to your baby and that would be the negative side of it. But there reason we recommend exclusive breastfeeding is that you can reduce your chance of transmitting the HIV to the baby through breast milk by only using breast milk and not introducing or not giving anything other than, not water not food and any other types of milk. And the reason for that is that babies tummies and guts are immature and if we do anything to make that weaker by causing inflammation or irritation then there is more chance that germs can get inside germs and HIV can get inside.

Shalom: Would you say its relatively safe to breastfed exclusively?

Dr Diana: It would properly reduce risk by one to four percent. So you still have a one to four percent chance even using all the ideals circumstances with breastfeeding of transmitting the infections. The reason it maybe safer for you to breastfeed even though you have the one to four percent chance of giving the virus is that you may have a high much higher chance of your baby dying from diarrhea or respiratory infection. And in fact if there is a higher rate of infant death in your community the chances maybe six times higher as breastfeeding.

Busi Maqungo: Given the fact that there is still four percent as you put it that umntwana ngakwazi ukuthi asuleleke yi HIV through breast milk. I think mna if I were to choose I would choose bottle feed even although uzibeka izizathu zoba if umntwana akabrestfeed usetsasini mhlawumbi anagasweleka zezinye zezinto like i-diarrhea and staff. But then am thinking izinto ezinjalo zingakwazi ukuba zingakhuselwa through omama kuqala bafundiswe banikwe i-education into yokuba. Now that you're not going to breastfeed and you are going to bottle feed these are the dangers of bottle feed these are the dangers of bottle feeding. So to prevent that you have to follow one two three for instance neatness izaba important. Ukuhlamba ibotile uku sterliza ibotile which doesn't cost anything. [IsiXhosa] Given the fact that there is still four percent as you put it that your baby might get infected with HIV through your breast milk. I think If I had the choice I would choose to bottle feed even though you've mentioned that babies that are not breast fed are at risk of dying from things like diarrhea. I think things like that can be avoided by empowering mothers with education, now that you're not going to breastfeed and you are going to bottle feed these are the dangers of bottle feed these are the dangers of bottle feeding. So to prevent that you have to follow one two three for instance neatness would be important, washing ans sterilising the the bottle which does not cost anything.

Dr Diana: If a mother has decided the best thing for her and her child is to breastfeed, there are ways that she can reduce the chance of transmitting the virus is to exclusively breastfeed as we have already said. And also to make sure she is healthy as possible that she gets good nutrition. Ideally to have the most suppressed viral load that she could. So if she could stay on ARV's triple therapy that would be an ideal. That she uses condoms for any sex that she has during her time that she was breastfeeding so she didn't get a new infection. Because new infections send your viral load up as we know. If she had any tender breast or cracked nipples she didn't feed on that side and she made sure that the babies mouth is without sores and if there was any thrash to threat it straight away. And then when she got six months. And then when she gets to six months when that is the benefit of breastfeeding has been obtain that she rapidly wins and immediately changes from breastfeeding to no feeding that is a challenge in itself.

Busi: I was going to ask you is that realistic? I don't see it practically especially kwi cases zomama because these days umama kuqala kufuneka ahambe oyokusebenza aphindele back emsebenzini uzashiya umntwana nomntu. Abantu abakhoya abana zi patients nabantwana. Umntwana uzathi emnika olobisi say ungumama you choose to exclusively breastfeed you squeeze out ubisi you leave it with the nanny or whoever is looking after the child into yokuba baka sheke efeeda umntwana ngalo and then the person decides to give the child something else because sinento yoku cinga thina intoba umntwana xa ekhala ulambile okanye akahluthanga. Maybe you don't know that you child was feed something eyenye. [IsiXhosa] I was going to ask you is that realistic? I don't see it practically especially with regard to the mothers because they have to go back to work and leave her baby with a childminder. We know childminders are not particularly patient these days. Say you choose to exclusively breastfeed, you squeeze out some breast milk and leave it with the nanny or whoever is going to look after the baby and then the person decides to give your baby something else because we tend to think that if a baby cries, it means they're hungry. Maybe you won't even know that you baby's been given something else.

Nokubonga Yawa: Xana ulazi ukuba lixesha lakho loba ubuyele emsebenzini., kufanele wenze sure ukuba lomntu ozoshiya umntwana akhonto angayaziyo. Kulapho ke sithi kubalulekile uku disclose xana uHIV positive, because lomntu uzoshiya kuye umntwana akakwazi ukubana uHIV positive and akayazi ukubana umntwana wakho kufuneka encanciswe ibele qha ayikho enye into ayityiswayo akatyiswa manzi, akatyiswa papa akafunekanga atyiswe mayeza athini. [IsiXhosa] If you know that you have to go back to work, you must ensure that whoever is going to look after the baby knows everything. Now this us back to the importance of disclosing if you're HIV positive because if your childminder doesn't know you're HIV positive, they won't know that your baby only gets breast milk and no water, porridge, medicine or anything else.

Shalom: Siyabuya, hlala nathi. [IsiZulu] We'll be back, stay where you are.

Shalom: Siyanamukela futhi kuSiyayinqoba Beat It! Sicoca ngokuthi uma ungumama onegciwane lengculaza ungayi ncelisa kanjani ingane yakho. Akhe sibheke loludaba lwase Khayelitsha eWestern Cape. [IsiZulu] Welcome back to Siyayinqoba Beat It! We are talking about how to feed your baby if you're a mother living with HIV. Let's take a look at this story from Khayelitsha in the Western Cape.

Luvuyo Nibe: Molweni babukeli emakhaya, namhlanje sise Khayelitsha eSite B ko Y section eQambi Street. Sithetha no Nomfuzo Wece about i-bottle feeding. Masambeni soveni. [IsiXhosa] Hi, today we're in Site B Khayelitsha, Y Section, Qampi Street. We're talking to Nomfuzo Wece about bottle feeding. Let's go meet her.

Nomfuzo Wece: I-age yam ndina 22 years ndakhulelwa last year then nda testa positive. And then ndalandela isupport group sakwa Mother to Mother. Nditsuze ibottlefeeding kuba ibalulekile apha kum. Because ngokuyana bendimane ndi attenda phaya ekliniki besixelelwa like izinto ezinjena.Then umntu ongenayo ondibuzayo kutheni ndimncancisa ibhotile, ndiye ndithi ndiyathanda ukuncancisa ibhothile yi choice yam. Mna umntwana wam ndizakumncancisa for 6 months ibhotile. Emva koba ndim feeder for 6 months ndizakukwazi ukuthi ndimtyise ukutya. Andike ndifike kusithiwa no ubisi alukho phaya ekliniki andizolufumana ndiyalufumana, yonke imihla. Umntu ufuma amabisi ayi ten ngenyanga. Ayandilasta inyanga yonke then for instance xa ndiphinde ndiyokuthatha if ndibekelwe lo date ifika lodate ndisenawo amabisi amathathu okanye amabini. Xa umix feeder umntwana uyakwazi ukuthi makagule yabo. For instance ukuncancisa ibele then ibhotile uyakwazi ukuthi agule. So ukufuneka unga mixfeedi umntwana. Ukuba uncancisa ibhotile umncancise ibhotile ukuba umncancisa ibele umcancise ibele ledwa. I-information endayifumanayo ekliniki ngokuncancisa ibhotile bathi ibhotile ibaluleke kakhulu and then xa uncancisa ibhotile kufuneka uthi make sure ukuthi iskoni ngawo onke amaxesha. Uvasa izandla zakho, uziphure. Ubeke amanzi abile uhlambe ngebrush le yokuhlamba ibhotile zabo. Uhlambe isiciko sebhotile , uhlambe ititi yalpha ngaphakathi, uhlambe lanto le ijikeleza ibothile. Emva koko uphure ititi nengono ugalele intwana yetyiwa phaya ukukhupha ezantsolongwane. Upholise amanzi akho aphole abedikidiki amanzi omntwana ugalele ubhotileni ugalele itispuni zakho. Ukuba yile incinci ibhotile ugalele itispuni zibe yi 5. Mna umntu ofidayo one HIV mna ndimcebisa mna ukuba makasebenzise lento ayisebenzisayo. If ebenikwe umyalelo ekliniki ukuba makasebenzise ubisi makasebenzise olabisi lwase kliniki. And then athi keep on doing lonto ahambe ayoluthatha ubisi angatyafi angaphelelwa mandla. If umntu usebenzisa ibele mna ndimcebisa ukuthi makasebenzise ibele lodwa no ezinye izinto. [IsiXhosa] I'm 22 years old and I fell pregnant last year. I tested positive and decided to join the Mother to Mother support group. I chose bottle feeding because it's best for me, because at the clinic they taught us everything about these things. If anybody asks me why I'm not breastfeeding, I tell them I like bottle feeding. It's my choice and I'm going to bottle feed my baby for 6 months. Then after 6 months I can give her food. They never sat they don't have formula milk at the clinic. I get it every time. Everybody gets 10 tins of milk a month. They last me for the whole months and sometimes when I go there for me, I still have 2 or 3 formula milk tins from the previous month. If you mix feed, your baby might get sick. You shouldn't give them formula and breast milk at the same time. So you shouldn't mix feed. It's either you exclusively bottle feed or you exclusively breastfeed your baby. The information I got from the clinic taught me that the bottle is very important and the importance of keeping baby bottles clean all the time. You wash and rinse your hands. Use warm water and a brush to clean the bottle inside. Wash the cap and tit and the ring around the bottle. Rinse the tit and rub a little bit of salt in it to kill the small germs. Prepare like warm water on the side, to mix with your formula milk. For the small bottle I used about 5 teaspoons of the formula. I would like to advise all the mothers living with HIV to stick to what they're using. If you were advised at the clinic to use formula milk then stick to it. Go and get more formula from your clinic, don't be crazy. Same goes if you're breastfeeding, say no to anything else.

Shalom: uNomfuzo ubukeka engenakinga ngokufunza ingane yakhe kodwa makhe sicoce ngokuncelisa ingane ibhodlela uma ungayincelisi ibele. Nina nithini? [IsiZulu] Nomfuzo seems to be doing so well feeding her baby, but let's discuss some of the issues around using the bottle when formula feeding. What do you think guys?

Busi: Am never against breastfeeding am never. I would love to see everyone to breastfeed. But with this HIV thing we know that we have risks that we don't want to put our kids on. But then one of the things I know about breastfeeding is that it has been promoted so beautifully. In our clinics , you walk in our clinics you found the posters promoting breastfeeding and staff and staff. But ke ngoku kukho kune HIV. Omama nangona bengafuni besazi into yokuba bayenzela abantwana babo into yokuba banga breastfeed, ukuba bangabasuleli nge HIV. But the kukho esa sazela soba xandingamncancisi umntwana ufeelisha u-guilty. Isazela soba ikhona into ewrongo endingamnikanga okanye ikhona into endimbambezela kuyo umntwana wam. So mna I would love to see ibottle feeding nayo especilly with this HIV , nayo ipromotwa as much as breastfeeding. So that ukuba umama uyayenza ayenze with confidence azive naye ene confidence uyayibona iyapromotwa ezibhedlele nase zikliniki. [IsiXhosa] I am never against breastfeeding, never. I would love see everyone to breastfeed. But with this HIV thing we know that we have risks that we don't want to put our kids on. But then one of the things I know about breastfeeding is that it has been promoted so beautifully. In our clinics , you walk in our clinics you found the posters promoting breastfeeding and staff and staff. But now with this HIV mothers are trying to protect their babies by not breastfeeding, and in that way protecting the babies from contracting HIV, and there is that sense of guilt. They feel like they're taking something special from their babies. So I would love to see bottle feeding, especially with HIV, being promoted as much as breastfeeding. So that those who choose to bottle feed can do it with confidence, knowing that it's being promoted in hospital and clinics

Nokubonga: Ibali lika sis ndiyalithanda ngoba umile kulento amekuyo, uzixelele ukuba umntwana wakhe uzakumncancisa ibisi emncancisa ngebhotile ibisi lakhe. Yinto endayenzayo nam leyo ndazixhelela. Ndachaciselwa nge HIV, ndateswa ndaya kwi PMTCT then ndacaciselwa phaya like ukubaluleka ukuncancisa umntwana ibele yonke lonto leyo. And again kubaluke njani fori mna ke mntu one HIV ukuba ndimncancise ibhotile zonke ezozinto ezo. Ndayazi ukuthi ibisi ndizakulifumana ekliniki and yonke into izakuba right fori mna. So ndazixelela ukuba eyona nto iright fori mna yintoba mandimncancise ibhotile wam umntwana. [IsiXhosa] I love Nomfuzo's story. She took the decision to formula feed using a bottle she's sticking to it. I did the same thing, I tested HIV positive and I went on PMTCT programme. They explained both advantages of breastfeeding and bottle feeding to me as an HIV positive mother. I knew I would get formula from the clinic and that everything would be fine. So I took the decision to bottle feed.

Busi: Siyayzi ukuba sifumana ipressure kwi family zethu, kukho ipressure kwi community zethu and the stigma these days on not breastfeeding. The minute you don't breastfeed everybody knows that une HIV. You find yourself forced ukuthi mandimcancise lomntwana nengxa yezinto ezinjalo but ke kwimeko ezinjalo I think singagxininisa xa uzufumana uphantsi konxinezelo olunjalo eloba uzifumanise uncancisa ibele I think iyakubaluka bafundiswe why okokuqala kufeneka unga mix feedi. Yintoni ubungozi bokumix feeder. Ayazilonto leyo. Two kufuneka umama lo ayazi ukuba ungancancisa up to ixesha elingakanani, awunakuwazi ukuqhitha kwixesha elithile because ukubangabe utshiba inyanga ezintandathu u-exclusively breastfeed lonto leyo isambeka umntwana okanye iyazengeza ishansi zoba umntwana ayifumane iHIV. [IsiXhosa] We know that there's pressure from our families and communities and the stigma these days on not breastfeeding. The minute you don't breastfeed everyone knows that you have HIV. You find yourself forced to breastfeed because of things like that, but I think mothers who find themselves under such pressure to breastfeed I think we need to be educated about why they should never mix feed. They need to be clear about the dangers of mix feeding. Secondly, they should know that they can only breastfeed for a certain period because if they breastfeed exclusively for over six months, there's still that chance of passing HIV to their babies through breast milk.

Dr Diana: Either you are going to do formula feeding as replacement feeding or whether you going to do exclusive breastfeeding both of them require a lot of support and both of them require education. And the bottom line is the replacement feeding is going to end up being expensive but if you can afford it it's the safest thing. It maybe but for the other reasons that you have already mentioned apart from the risks, the difficulties of exclusive breastfeeding requires support not only from your clinic but also from your community. And if you breastfeed because of a discloser issue you may not get that support. So I think a lot more could be done to support moms in both camps. For those who have either financial or acceptability reasons or fees ability reasons chosen to breastfeed. And those who are formula feeding to totally eradicate the risk.

Shalom: Unganyakazi sithathi ikhefu siyabuya manje. [IsiZulu] We're taking a quick break don't go away.

Shalom: Siyanamukela ku Siyayinqoba Beat It! Siyanamukela futhi kuSiyayinqoba Beat It! Sicoca ngokuthi omama abanegciwane lengculaza bangazipha kanjani ukudla izingane zabo. Akhe sibheke indlela eziphephile zokwenza lokhu. [IsiZulu] Welcome back to Siyayinqoba Beat It! We're taking about how moms living with HIV can feed their babies. Let's check out the safest feeding options.

Luvuyo Nibe: Namhlanje sise Chris Hani eKhayelitsha size kusisi Zimasa ozazibonisa nge Cup feeding. [IsiXhosa] Today we're in Khayelitsha in Chris Hani Park to talk to Zimasa about cup feeding.

Zimasa Bheshenga: Mna ndingu Zimasa Bheshenga ndihlala apha eChris Hani e Site C. Ndi HIV positive ndinabantwana bathathu. Ukuba ndi HIV positive ndizazi kuolmntwana ndimphetheyo, uLiyema ona seven months. Umntwana utestiwe unegative. [IsiXhosa] I'm Zimasa Beshengu from Chris Hani Park in Site C. I'm HIV positive and I have three children. I found out about my status with my third baby, Liyema, he's seven months old. He tested HIV negative.

Vuyo: Ekliniki waxelelwa ngendlela ezingaphi zokufida umntwana ? [IsiXhosa] At the clinic,l did they tell you about the different ways of feeding you baby?

Zimasa: Ndaxelelwa ngendidi ezithathu zokifida umntwana. Kema ke nda tshuza i-exclusive formula feeding nge cup kange nditshu nge bhotile. [IsiXhosa] I was taught about three different ways and I chose exclusive formula feeding, with a cup not a bottle.

Vuyo: Kutheni nje sis wena watshuza i-cup feeding?[IsiXhosa] Why did you choose cup feeding?

Zimasa: Ndaqala ndacaciselwa phayana ukuthi icup yeyona ibalulekileyo and yeyona ilula and ayina zirisks zoba umntwana angasuleleka zintsholongwane and kulula ukuyiclena. Ndiza kum cup feed ade abe nonyaka umntwana and after that uzabe sesitya kengoku. And futhi sefumana ezibhotile zithengwayo so ndiza kum feeda ngayo. [IsiXhosa] They said cup feeding is the most safe and it is the easiest and it carries less risks of your baby getting infections and the cup is easy to clean. I'm going to cup feed him until he's one year old and then he will be ready for normal food. Then I can also buy a baby bottle and use that to feed him.

Vuyo: Ingaba nawe ufuma ubisi njengonmtu owenza ibottle feeding? [IsiXhosa] Do you get formula milk just like bottle feeding mothers?

Zimasa: Xasele ubhukishile kufumanise ukuba uHIV positive uye ukhethelwe amabisi noba uya cup feed noba uya bottle feed uyathatha for six months. So ikhona icup icup oyinikwayo kwaphay esibhedlele ye new born ehamba ne cup enkulu for umntwana xa sele emdala. So awutshuzi nokuba yeyiphi icup, unikwa I cup ene measurements ezifanayo ne bhotile. Kwabanye omama abakulelweyo abasezaba nabantwana ndibacebisa ukuthi maba tshuze i-cup feeding cause i-cup feeding yeyona ingcono kakhulu. Njeba senditsilo kukula ukuyi klina. Uyiklina ngokulula and yona ayina zi risks zoba umntwana afumane iHIV okanye asuleleke kwi HIV. Ne infections akakwazi umntwana ukuthi asuleleke kuzo, ngoba thina si careless apha ematyotyombeni, ukwazi ukubeka ibhotile careless ungayicibekelanga umntwana then uthathe labhotile umncancise. Yona icup feeding is the best. [IsiXhosa] If you're HIV positive, you get formula milk. Whether you're cup feeding or bottle feeding, you get formula for six months. They give you a cup for your new born baby as well as a bigger cup for when you baby's bigger You don't just use any cup they give you one with measurements. I'd advise other mothers to choose cup feeding because it is the best. Like I said, it's much easier to clean and there's less chance of your baby getting HIV (from mother) or other infections. We're careless in these shacks, we leave baby bottles lying around with no caps on and then we just take it and feed the baby. So cup feeding is the best.

Nokubonga: Ndinomdla kakhulu yilento ndiqhiba kuyibona apha ye cup feeding ngoba ndiyaqala ukuva ngayo and ndiyaqala ukubona ukuthi yenzeka njani yonke lonto leyo. And ndicinga ukubangana nelaxesha phaya ekliniki ugqirha waye busy endixelela mandincancise umntwana if bana wayendixelele nge cup feeding maybe mhlawumbi ngendandi tshoze yone because ibonakala ilula, ngoba uyihlamba ngoku uyenzele umntwana ngoku umselise ngoku after uqhibile uyayihlamba uyayibeka.[IsiXhosa] I'm very fascinated by cup feeding because this is the first time I hear about it and see it how it actually works. I think that if the doctor, instead of encouraging me to breastfeed, had actually told me about cup feeding. I would have chosen it because you wash now, feed the baby and wash it again, easy

Busi: Umntwana we cup feeding ibakhona labond. With ibottle feeding uyakwazi nokuba uthathe umntwana thina phaya ezilokishini uthatha umntwana noba mcinci kangakanani umbeke ebhedini umsekele ubeke ibhotile yakhe azincancele, wena uqhubekeke nezinye izinto. But with icup feeding awunakukwazi ukuyenza lonto leyo kufuneka umenzele ibisi lakhe umthathe umbeke apha kuwe umfeede. But kim this is a new thing really I never heard about it. I didn't know even the clinics you chose to cup feed they actually provide you with a cup because mna I thought this cup feeding means the normal cup that I know that I have at home. I didn't know that their actually provide you with the measurements, with icup le ine measurements njenge bhotile. So I think it makes it easy. [IsiXhosa] With cup feeding you can still bond with you baby because with bottle feeding, we put the baby on the bed on his side, balance the bottle with something and he can suck on his own while I do something else but you can't do that with cup feeding. You have to prepare the food and hold the baby when feeding him. This is a new thing to me. Really I have never heard about it I didn't know that the clinics if you chose to cup feed they actually provide you with the cup. I thought this cup feeding means the normal cup that I know that I have at home. I didn't know it is a cup that has measurements just like a bottle .So I think it makes easier .

Nokubonga: But mna into endinokuyikhuthaza kumama ukulelweyo phambi kokuba abeleke engekabeleki kubaluleki ukuba anikezwe ulwazi olwaneleyo i-information epheleleyo ukwenzela ozathatha ixesha azifune into yoba ingaba yena ngokohlobo aphila ngalo yeyiphi ayibona ingathi imfanele for umntwana wakhe. [IsiXhosa] I would like to advise that pregnant women be informed about these feeding options way before they give birth. So that they can take time in choosing the option that would suit their living conditions.

Shalom: Come to think about it mina ke ngiyayibona futhi engi sutayo yi cup feeding. Should I have a baby nzaku cup feeda because zininzi enzinye izinto zale cleanliness endingazithembiyo. Am I really really confident ukuba ndizakuyenza ndizakuyiqhuba ngaleway yenziwa ngakhona indaba we bottle feeding. But it is quite simple the way usisi lo ebevelile pha lo ebesenza icup feeding. [IsiXhosa] Come to think of it, I think cup feeding would suit me best. Should I have a baby, I'm going to cup feed because of all this fuss about cleanliness. I don't think I'd be confident enough to do this bottle feeding thing. But I think it's quite simple the way Zimasa showed us.

Dr Diana: I think that breastfeeding and formula feeding in any contest is a very emotive issue and people are either very pro one or pro the other. But in the issue of HIV and breastfeeding verses formula feeding there are certain scientific facts and those are the facts that aren't emotive that is why I think presenting the numbers to people to make their own decisions. And they can make decisions on their risks or what their risks are in their own social situation which only they can know.

Shalom: Minyaka yonke kunezingane ezingamashumi amthathu ezinkhulungwane 30 000 ezigcina zisulelwa leligciwane ngenxa yokuphiwa ukudla ngendlela engafanele. Kumbhula ukuthi omama abanegciwane lengculaza abakwazi ukuncelisa babe bezipha ukudla noma ukuziphuzisa amanzi izingane zabo. Zihlomise ngokubambhelela endleleni eyodwa yokunika ingane ukudla uze wena nengane yakho nibe nempilo enhle. Omama bangazivikela bavikele nezingane zabo ngokungaxubi indlela yokuzipha ukudla kanye nokuncelisa. Zivikele uvikele nengane yakho. Lamabhengele atso ukuthi sizibophezele futhi siyazivikela. Siyabonga. Salani kahle. Bye Bye [IsiZulu] Every year 30 000 kids are infected with HIV through incorrect feeding. Remember, moms living with HIV cannot mix breastfeeding with any other type of feeding, not even water. Empower yourself by making one choice for feeding and sticking to it and you and you baby will stay healthy. Mothers can protect themselves and protect their babies by not mixing breastfeeding with any other type of feeding. Protect yourself and protect your baby! These bangle show that we're taking responsibility and keep it safe. Protect yourself, protect others. Thanks for watching, bye bye.