SciELO - Scientific Electronic Library Online

vol.15 número1A model for higher education campus health servicesCoping responses as predictors of satisfaction with life amongst a group of patients diagnosed with diabetes mellitus índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados



Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Em processo de indexaçãoSimilares em Google


Health SA Gesondheid (Online)

versão On-line ISSN 2071-9736
versão impressa ISSN 1025-9848

Health SA Gesondheid (Online) vol.15 no.1 Cape Town  2010




Factors affecting mothers' choice of breastfeeding vs. formula feeding in the lower Umfolozi district war memorial hospital, KwaZulu-Natal



Susan Swarts; H. Salome Kruger; Robin C. Dolman

Centre of Excellence for Nutrition, North-West University, South Africa





The aim of this study was to determine which factors influence choice of breast- versus the formula-feeding of infants. This may help to understand where the focus should lie in the promotion of breastfeeding. A structured questionnaire was completed by a 100 women and focus-group discussions were held with 22 women who delivered babies at the Lower Umfolozi District War Memorial Hospital (LUDWM) in Kwazulu-Natal. Most of the mothers (72%) chose breastfeeding and 58% intended to breastfeed for only 6 months. One-third (33%) were influenced by health care professionals and 44% of the mothers made their own decisions in their feeding method. Only one participant stated that she chose formula-feeding due to her HIV-positive status, but in the focus-group discussions, the fear of transmission of HIV through breast-milk was stated as an important reason why mothers chose replacement-feeding. Significantly more HIV-infected than uninfected mothers chose replacement-feeding as the feeding method and mothers who chose breastfeeding were significantly older than mothers who selected replacement-feeding. They made their infant-feeding decision earlier than those who chose replacement-feeding. Findings showed that the majority of women in this study did not have access to running water and flush toilets in their houses. In these areas where replacement-feeding will not be acceptable, feasible, affordable, sustainable and safe, due to lack of sanitation and poor socio-economic status, health professionals should promote exclusive breastfeeding for 6 months, even though there is a high prevalence of HIV infection.

Keywords: exclusive breastfeeding; HIV; Infant-feeding; ;mixed-feeding; mother-to-child-transmission


Die doel van die studie was om te bepaal watter faktore vroue in hulle keuse van bors- of bottelvoeding beïnvloed. Dit sal help om te verstaan op watter faktore gesondheidswerkers moet fokus wanneer borsvoeding bevorder word. 'n Gestruktureerde vraelys is voltooi deur 100 vroue en fokusgroepbesprekings is met 22 vroue wat by die Laer-Umfolozi Distrik Gedenk-hospitaal (LUDWM) geboorte geskenk het gehou. Die meerderheid vroue (72%) het borsvoeding gekies, 58% het voorgeneem om vir 6 maande te borsvoed. 'n Groot aantal vroue (97%) het inligting oor babavoedingskeuses by gesondheidswerkers ontvang. Een derde van die vroue (33%) is deur die gesondheiswerkers beïnvloed en 44% van die deelnemers het aangedui dat niemand hulle beïnvloed het nie. Beduidend meer MIV-geïnfekteerde as ongeïnfekteerde moeders het kunsvoeding bo borsvoeding verkies. Net een moeder het gerapporteer dat sy kunsvoeding gekies het as gevolg van haar MIV-positiewe status, maar in die fokusgroepbespreking is die mening gelug dat die vrees van MIV oordrag deur borsmelk grootliks bygedra het dat MIV geïnfekteerde moeders kunsvoeding gekies het. Die moeders wat borsvoeding gekies het was beduidend ouer en het die voedingsmetode beduidend vroeër gekies as die wat kunsvoeding gekies het. Die resultate dui aan dat kunsvoeding nie aanvaarbaar, uitvoerbaar, bekostigbaar, volhoubaar en veilig is in die studie-area nie, as gevolg van swak sanitasie en die swak sosio-ekonomiese toestande. Gesondheidswerkers behoort dus eksklusiewe borsvoeding vir die eerste ses maande te bevorder, al is die prevalensie van MIV-infeksie hoog.



“Full text available only in PDF format”




Averting HIV and AIDS (AVERT), 2007, 'HIV and AIDS statistics for South Africa', viewed 05 June 2007, from        [ Links ]

Bobat, R., Moodley, D., Coutsoudis, A. & Coovadia, H., 1997, 'Breastfeeding by HIV-1-infected women and outcome in their infants: A cohort study from Durban, South Africa', AIDS 11(13), 1627-1633.         [ Links ]

Bland, R.M., Rollins, N.C., Coovadia, H.M., Coutsoudis, A. & Newell, M.L., 2007, 'Infant feeding counselling for HIV-infected and uninfected women: Appropriateness of choice and practice', Bulletin of the World Health Organization 85(4), 289-296.         [ Links ]

Chezem, J., Friesen, C. & Clark, H., 2001, 'Sources of infant feeding information used by pregnant women', The Journal of Perinatal Education 10(3), 20-26.         [ Links ]

Coovadia, H.M., Rollins, N.C., Bland, R.M., Little, K., Coutsoudis, A., Bennish, M.L. & Newell, M.L., 2007, 'Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study', Lancet 369(9567), 1107-1116.         [ Links ]

Coutsoudis, A., Pillay, K., Kuhn, L., Spooner, E., Tsai, W. & Coovadia, H.M., 2001, 'Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: Prospective cohort study from Durban, South Africa', AIDS 15(3), 379-387.         [ Links ]

Coutsoudis, A., Goga, A.E., Rollins, N. & Coovadia, H.M., 2002, 'Free formula milk for infants of HIV-infected women: Blessing or curse?', Health policy and planning 17(2), 154-159.         [ Links ]

Department of Health (South Africa), 1998, 'South Africa Demographic and Health Survey', viewed 05 June 2007, from        [ Links ]

Department of Health (South Africa), 2003, 'South African Demographic and Health Survey', viewed 05 June 2007, from        [ Links ]

Doherty, T., Chopra, M., Nkonki, L., Jackson, D. & Greiner, T., 2006, 'Effect of the HIV epidemic on infant feeding in South Africa: "When they see me coming with the tins they laugh at me"', Bulletin of the World Health Organization 84(2), 90-96.         [ Links ]

Fowler, M.G., 2008, 'Further evidence that exclusive breastfeeding reduces mother-to-child HIV transmission compared with mixed feeding', PLOS Medicine 5(3), 359-361.         [ Links ]

Grossman, L.K., Fitzsimmons, S.M., Larsen-Alexander, J.B., Sachs, L. & Harter, C., 1990, 'The infant feeding decision in low and upper income women', Clinical pediatrics 29(1), 30-37.         [ Links ]

Gara, C.P., Pazvakavambwa, I., Maponga, C.C. & Gavaza, P., 2005, 'An investigation of the factors influencing the choice of infant feeding methods among urban Zimbabwean women in the context of HIV transmission', Central African Journal of Medicine 51(1-2), 1-4.         [ Links ]

Kent, G., 2006, 'Child feeding and human rights', International breastfeeding journal 1(27), 1-12.         [ Links ]

Kloeblen-Tarver, A.S., Thopson, N.J. & Miner, K.R., 2002, 'Intent to breastfeed: The impact of attitudes, norms, parity, and experience', American journal of behavior 26(3), 182-187.         [ Links ]

Kong, S.K.F. & Lee, D.T.F., 2004, 'Factors influencing decision to breastfeed', Journal of advanced nursing 46(4), 369-379.         [ Links ]

Ludvigsson, J.F., 2003, 'Breastfeeding in Bolivia - information and attitudes', BioMed Central Pediatrics 3(4), 1-12.         [ Links ]

Minnie, C.S. & Greeff, M., 2006, 'The choice of baby feeding mode within the reality of HIV/AIDS epidemic: Health education implications', Curationis 29(4), 19-27.         [ Links ]

Marchand, L. & Morrow, M.H., 1994, 'Infant feeding practices: Understanding the decision-making process', Family Medicine 26(5), 319-324.         [ Links ]

Pérez-Escamilla, R., 2007, 'Evidence based breastfeeding promotion: The Baby-friendly Initiative', The journal of nutrition 137(2), 484-487.         [ Links ]

Piwoz, E.G., Humphrey, J.H., Tavengwa, N.V., Iliff, P.J., Marinda, E.T., Zunguza, C.D. et al., 2007, 'The impact of safer breastfeeding practices on postnatal HIV-1 transmission in Zimbabwe', American journal of public health 97(7), 1249-1254.         [ Links ]

Piwoz, E.G., Ferguson, Y.O., Bentley, M.E., Corneli, A.L., Moses, A., Nkhoma, J., et al., 2006, 'Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi', International breastfeeding journal 1(2), 1-8.         [ Links ]

Rollins, N.C., Becquet, R., Bland, R.M., Coutsoudis, A., Coovadia, H.M., & Newell M.L., 2008, 'Infant feeding, HIV transmission and mortality at 18 months: The need for appropriate choices by mothers and prioritization within programmes', AIDS 22(17), 2349-2357.         [ Links ]

Shaker, I., Scott, J.A. & Reid, M., 2004, 'Infant feeding attitudes of expectant parents: Breastfeeding and formula feeding', Journal of advanced nursing 45(3), 260-268.         [ Links ]

World Health Organization, 2000, 'WHO Collaborative study team on the role of breastfeeding on the prevention of infant mortality effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: A pooled analysis', Lancet 355(9202), 451-455.         [ Links ]

World Health Organization, 2006, 'WHO HIV and infant feeding technical consultation held on behalf of the Inter-Agency Task Team (IATT) on prevention of HIV infections in pregnant women, mothers and their infants', Oct 25-27, WHO, Geneva.         [ Links ]



Salome Kruger
Centre of Excellence for Nutrition, North-West University
Private Bag X6001
South Africa

Received: 09 July 2009
Accepted: 17 Mar. 2010
Published: 04 Nov. 2010

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons