Marseille 2007
| Abstract #444 - Exclusive breastfeeding: interpretations and limits in Burkina Faso | ||||
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Session: 17.4: Challenges for Children (Parallel) on Monday @ 14.00-16.00 in Auditorium/Overflow Chaired by Patrice Engle, Christina Noestlinger Authors: Presenting Author: Dr Chiara Alfieri - CReCSS, France |
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| Additional Authors: | ||||
| Aim: Following WHO/UNICEF/UNAIDS recommendations, Programs for Prevention of Mother-to-Child Transmission of HIV request that HIV+ mothers make an informed choice between exclusive breastfeeding with early weaning and formula feeding. In countries such as Burkina Faso, where most women breastfeed their infants with a 25 months mean duration, most HIV+ women select the first option that, at the time of choice, seems to be the most accessible in their socio-economic context. Thus, it is important to know womens perceptions of the exclusive character of breastfeeding, how they interpret this notion, their related practices and difficulties that may occur in everydaylife. | ||||
| Method / Issue: Qualitative investigations (within ANRS 1271 research project) have been carried out through repeated interviews with 45 mothers, included either in WHO Kesho Bora trial or in PMTCT national programme, in Ouagadougou and Bobo-Dioulasso. | ||||
| Results / Comments: HIV+ mothers must face general popular perceptions about the need for infants to get water for their growth. Interviewed women explained that, as a result of counselling, they could use medical discourses from Mother and Child Health Centers to oppose these perceptions. Campaigns for exclusive breastfeeding for all babies held during the last few years have partly influenced popular perceptions, at least in urban settings, creating a more propitious background for some women. However, when applying preventive recommendations about exclusive breastfeeding, women meet mainly two kinds of difficulties: i. related to avoidance of water up to six months; ii. related to traditional treatments for infants. Regarding avoidance of water and other liquids, field data show various situations: some mothers perfectly manage to do it; most women apply it partly; some can do it now and then; a few ones cannot apply it at all. The most propitious situation is when the mothers partner knows her HIV status and supports her facing a hostile family circle. Women that can practice exclusive breastfeeding without any constraint are literate women with a minimum of economic autonomy and may more easily impose their choice whatever critics by their family circle may be. But most women seem to apply partly exclusive breastfeeding: they can fully apply it only when they stay with their infant in an exclusive relationship. Entrusting the baby to other women, relatives or neighbours, even for a short moment, would systematically expose the infant to be given other liquids. Any socialization of the infant within the family or the neighbourhood is a limit to the exclusiveness of mother-child relationship, thus of breastfeeding. Regarding avoidance of traditional treatments for infants, using liquids or not, women face difficulties when their baby gets ill. Several women reported they had to treat their baby with traditional medicines, because they were suffering from diseases understood according to traditional nosology; others explained they had to use traditional and biomedical paediatric treatments. | ||||
| Discussion: Even when feasible, exclusive breastfeeding is not easy for women, due to social and cultural reasons that must be considered in implementation of prevention. | ||||
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