Are WHO/UNAIDS/UNICEF-Recommended Replacement Milks for Infants of HIV-Infected Mothers Appropriate in the South African Context?
Postprint version. Published in Bulletin of the World Health Organization, Volume 82, Issue 3, March 1, 2004, pages 164-171.
>NOTE: At the time of publication, the author Peggy Papathakis was not yet affiliated with Cal Poly.
ObjectiveLittle is known about the nutritional adequacy and feasibility of breastmilk replacement options recommended by WHO/ UNAIDS/UNICEF. The study aim was to explore suitability of the 2001 feeding recommendations for infants of HIV-infected mothers for a rural region in KwaZulu Natal, South Africa specifically with respect to adequacy of micronutrients and essential fatty acids, cost, and preparation times of replacement milks.
Methods Nutritional adequacy, cost, and preparation time of home-prepared replacement milks containing powdered full cream milk (PM) and fresh full cream milk (FM) and different micronutrient supplements (2 g UNICEF micronutrient sachet, government supplement routinely available in district public health clinics, and best available liquid paediatric supplement found in local pharmacies) were compared. Costs of locally available ingredients for replacement milk were used to calculate monthly costs for infants aged one, three, and six months.Total monthly costs of ingredients of commercial and home-prepared replacement milks were compared with each other and the average monthly income of domestic or shop workers. Time needed to prepare one feed of replacement milk was simulated.
FindingsWhen mixed with water, sugar, and each micronutrient supplement, PM and FM provided
Conclusion No home-prepared replacement milks in South Africa meet all estimated micronutrient and essential fatty acid requirements of infants aged/UNAIDS/UNICEF HIV and infant feeding course replacement milk options are needed. If replacement milks are to provide total nutrition, preparations should include vegetable oils, such as soybean oil, as a source of linoleic and α-linolenic acids, and additional vitamins and minerals.
Food Science | Nutrition
2004 World Health Organization. This article is originally published in Bulletin of the World Health Organization