A Cluster Randomised Trial to Determine the Efficacy of the “Feeding Buddies” Programme in Improving Exclusive Breastfeeding Rates Among HIV-Infected Women in Rural KwaZulu-Natal, South Africa

Abstract

This cluster randomised trial in KwaZulu-Natal South Africa, evaluated the implementation of a Feeding Buddies (FB) programme to improve exclusive breastfeeding (EBF) amongst human immunodeficiency virus infected mothers. Eight clinics were randomly allocated to intervention and control arms respectively. Pregnant women attending the prevention of mother-to-child transmission program and intending to EBF were enrolled: control (n = 326), intervention (n = 299). Intervention mothers selected FBs to support them and they were trained together (four sessions). Interviews of mothers occurred prenatally and at post-natal visits (day 3, weeks 6, 14 and 22). Breastfeeding results were analysed (Stata) as interval-censored time-to-event data, with up to four time intervals per mother. EBF rates at the final interview were similar for control and intervention groups: 44.68% (105/235) and 42.75% (109/255) respectively (p = 0.67). In Cox regression analysis better EBF rates were observed in mothers who received the appropriate training (p = 0.036), had a community care giver visit (p = 0.044), while controlling for other factors. Implementation realities reduced the potential effectiveness of the FBs.

Psychosocial barriers and enablers of exclusive breastfeeding: lived experiences of mothers in low-income townships, North West Province, South Africa

“…Mothers have mentioned both the Family and Social environment more often as barriers than as enablers of EBF. In the context of our research setting, the lived realities of low-income households are plagued with food insecurity, hardship and strife (36, 73,80). EBF is an additional burden on an unsupported, unemployed breastfeeding mother who is physically the sole provider for the health and wellbeing of herself and her infant.…”

Psychosocial barriers and enablers of exclusive breastfeeding: lived experiences of mothers in low-income townships, North West Province, South Africa

“…Mothers have mentioned both the Family and Social environment more often as barriers than as enablers of exclusive breastfeeding. In the context of our research setting, the lived realities of low-income households are plagued with food insecurity, hardship and strife [36,69,70]. Exclusive breastfeeding is an additional burden on an unsupported, unemployed breastfeeding mother who is physically the sole provider for the health and wellbeing of herself and her infant.…”

“…The research was approved by the North-West University Health Faculty Research Ethics Committee (NWU-00030-17-S1) and the study was conducted in line with the Helsinki Declaration and the South African National Department of Health Ethics in Health Research guidelines [70]. All eligible participants signed a written informed consent and data were collected in the preferred language of the participants.…”

Psychosocial barriers and enablers of exclusive breastfeeding: lived experiences of mothers in low-income townships, North West Province, South Africa

“…Mothers have mentioned both the Family and Social environment more often as barriers than as enablers of EBF. In the context of our research setting, the lived realities of low-income households are plagued with food insecurity, hardship and strife [36,72,79]. EBF is an additional burden on an unsupported, unemployed breastfeeding mother who is physically the sole provider for the health and wellbeing of herself and her infant.…”

“…The research was approved by the North-West University Health Faculty Research Ethics Committee (NWU-00030-17-S1) and the study was conducted in line with the Helsinki Declaration and the South African National Department of Health Ethics in Health Research guidelines [79]. All eligible participants signed a written informed consent and data were collected in the preferred language of the participants.…”