Feeding Options

This week Siyayinqoba Beat It! examines the feeding options available to HIV positive mothers to ensure they do not transmit the virus to their babies. Mothers can choose to breastfeed or formula feed their babies. The HI virus can be transmitted to babies via breastfeeding if the correct treatment protocols are not followed, while formula feeding can also cause health complications through poor hygiene. It is crucial that whichever option mothers choose it is exclusive and they do not mix feed. In this episode we meet two mothers who are living with HIV, one who chose breast feeding and another who chose formula feeding, to find what mothers should do to protect their children.

Breast milk is considered to be the healthiest feeding option for babies, but it can transmit the HI virus from mother to child. Measures announced by the Government to allow HIV positive mothers to breastfeed include giving babies ARV drugs while they are being breastfed. Nontsapo Gcuda from Lusikisiki is HIV positive and knew that she should make regular trips to the clinic once she became pregnant so the staff could talk her through the PMTCT protocols designed to protect her baby. These included discussing feeding options with her and together they agreed that she would breastfeed exclusively for six months. She also gave her baby Nevirapine every day. Nontsapo was worried she had infected her child with HIV but after seven weeks her baby tested negative.

The hospital staff encourage all mothers to choose exclusive breastfeeding but are aware that it can be difficult for those who work or travel and so cannot be with their baby at all times. In these cases, the nurses teach the women how to express breast milk and feed their babies using a feeding mug rather than a baby bottle (because the teats, if not cleaned properly, can cause diarrhoea). Some mothers, like Nonhlanhla Goba who sometimes have to travel, choose formula feeding instead. This eliminates the risk of transmitting HIV through breast milk but also raises some concerns. The feed is expensive and while clinics do supply new mothers with feed for the first six months, after that or if the clinic runs out, mothers need to be able to buy their own. Mothers should not just switch to breast feeding as formula can cause erosion in the baby's gut or intestines - if an HIV positive mother then starts breastfeeding the abrasions in the stomach make it easier for the virus in the milk to infect the baby.

At the Gingindlovu Clinic, HIV counsellor Nonhlanhla Ngema explains some of the other issues around formula feeding such as lack of access to clean water, especially in rural areas. Health workers educate women about cleaning water, particularly for when their supply is cut off and they have to get water from rivers. Another challenge facing women who choose to formula feed is stigma. In communities where the cultural norm is to breastfeed, a woman who is seen to be formula feeding may be assumed to have the HI virus. It is important though that with the feeding options available to mothers they are made aware of the protocols to follow to ensure the safety of their children. Continuing to build on the hard work of the staff at clinics and expanding knowledge of the PMTCT protocols will ensure the safety of many more children in South Africa.