Oiye Shadrack, Mwanda Walter, Mugambi Mary, Filteau Suzanne, Owino Victor
1 University of Nairobi Institute of Tropical and Infectious Diseases (UNITID) , Nairobi, Kenya .
2 Department of Human Nutrition and Dietetics, Technical University of Kenya, Nairobi, Kenya .
Breastfeed Med. 2017 Jun;12:283-289. doi: 10.1089/bfm.2016.0126. Epub 2017 May 3.
To compare breastfeeding practices determined by mothers' own recall versus a stable isotope technique (deuterium oxide dilution) among human immunodeficiency virus (HIV)-infected and HIV-uninfected mothers at 6 weeks and 6 months postpartum.
Exclusive breastfeeding (EBF) rates were assessed cross-sectionally at 6 weeks and 6 months postpartum among 75 HIV-positive and 68 HIV-negative women attending postnatal care. EBF was derived from maternal 24-hour recall of foods that were fed to the infant and by objective measurement of nonhuman milk-water intake using deuterium oxide (DO) dilution technique.
Multivariable logistic analyses were adjusted for infant sex, gravidity, maternal age, marital status, and maternal education. Using recall method, a greater proportion of HIV-infected mothers exclusively breastfed than HIV-uninfected mothers both at 6 weeks postpartum [94.1% versus 76.9%, respectively (adjusted odds ratio [aOR] 7.81; 95% confidence interval [CI] 1.9-31.6, p = 0.004)] and at 6 months postpartum [75% versus 59.7%, respectively (aOR 2.27; 95% CI 1.0-5.3, p = 0.058)]. At 6 weeks postpartum EBF rates from the DO technique were 23.5% and 13.8% for HIV-positive and HIV-negative mothers, respectively (aOR 0.35; 95% CI 0.11-1.04, p = 0.059). At 6 months postpartum, the DO technique determined EBF rates were 43.3% among HIV-positive and 24.2% among HIV-negative mothers, respectively (aOR 2.4; 95% CI 1.0-5.7, p = 0.048).
HIV-infected mothers are more likely to exclusively breastfeed compared with HIV-uninfected mothers. In this resource-poor setting, maternal recall overestimates EBF rates as compared with the deuterium oxide dilution technique. Validating EBF recall data using the objective DO technique is highly recommended for accurate tracking toward global targets on breastfeeding practices.
比较人类免疫缺陷病毒（HIV）感染母亲和未感染母亲在产后6周和6个月时，通过母亲自身回忆与稳定同位素技术（氧化氘稀释法）确定的母乳喂养情况。
对75名HIV阳性和68名HIV阴性的产后护理女性在产后6周和6个月时进行横断面评估，以确定纯母乳喂养（EBF）率。EBF通过母亲对婴儿喂养食物的24小时回忆以及使用氧化氘（DO）稀释技术客观测量非母乳水分摄入量来确定。
多变量逻辑分析对婴儿性别、妊娠次数、母亲年龄、婚姻状况和母亲教育程度进行了调整。使用回忆法，产后6周时，HIV感染母亲纯母乳喂养的比例高于未感染母亲[分别为94.1%和76.9%（调整优势比[aOR]7.81；95%置信区间[CI]1.9 - 31.6，p = 0.004）]，产后6个月时也是如此[分别为75%和59.7%（aOR 2.27；95% CI 1.0 - 5.3，p = 0.058）]。产后6周时，HIV阳性和阴性母亲通过DO技术确定的EBF率分别为23.5%和13.8%（aOR 0.35；95% CI 0.11 - 1.04，p = 0.059）。产后6个月时，HIV阳性和阴性母亲通过DO技术确定的EBF率分别为43.
