A national campaign is needed to discourage shared breastfeeding as it is a potential risk factor for HIV in children, a study released by the Nelson Mandela Foundation (NMF) says.
Shared breastfeeding was once common among European nobility and is now common in many developing countries where the mother is unable to breastfeed and her baby is fed by another woman.
The call followed a study of 4 000 mother-and-child pairs in the Free State that showed that breastfeeding of babies by an HIV-positive caregiver posed the single greatest risk of HIV infection in children, besides mother-to-child transmission.
Researchers also found that prolonged breastfeeding by HIV-positive mothers increased the risk of HIV infection in children.
In the study, 92 percent of HIV-positive mothers breastfed their children - 60 percent of them for more than a year.
The study also found risks in hospitals in the management of expressed breast milk (milk a mother squirts into a container for later use).
Bottles were labelled by cot numbers, not the name of the baby, and were seldom checked, which allowed milk to be fed to the wrong baby if the cot was moved.
The investigation was conducted between April and July last year, with researchers trying to establish all possible sources of HIV-infection, besides mother-to-child transmission, among children in the Free State aged between two and nine.
It involved 25 public hospitals, three community health centres and 54 primary health care clinics and was conducted by the University of Stellenbosch, the Human Sciences Research Council, the Medical Research Council and the Centre for Aids Development Research and Evaluation, with the support of the Free State department of health and the Nelson Mandela Children's Fund.
Recommendations included discouraging prolonged breastfeeding, better control of expressed milk and a campaign to educate patients to demand better hygiene practices by health workers.
Poor infection control at dental, maternity and paediatric facilities was also possibly contributing to the spread of HIV and Aids, statistics showed.
Findings included that 24,6 percent of dental instruments ready to be used in patients' mouths, and 24% of instruments to be used for maternity and paediatric patients were contaminated with invisible blood, and 17,5 percent had visible blood on them.
"Results show there is very poor cleaning of the environment in the labour and maternity areas and in dental facilities - and the same is true for the baby and neo-natal areas," read a section of the report.
A lack of infection control may play a role in HIV transmission, the report said.
One of the most alarming findings was that only 1,65 percent of health professionals at hospitals and clinics surveyed knew that expressed mother's milk, pooled in many cases, had to be pasteurised before being fed to a baby.
"We went to brief the department of health, nationally, with regard to this particular study, so that they could take up some of the recommendations. Indeed they were very sympathetic when we met with them... (and felt) something has to be done," said Dr Olive Shisana, co-principal investigator.
Shisana, who was addressing a media conference, said the buck stopped everywhere in dealing with the recommendations.
"It doesn't just stop with the national department of health. It stops at the provincial departments of health and with the public for not being knowledgeable about what to expect from health workers." - Sapa
- This article was originally published on page 4 of Cape Times on April 06, 2005